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Abstract
Purpose
To investigate the effect of frequent use of artificial tears on dry eye syndrome (DES) by analyzing the changes in total protein concentration, lipocalin concentration, and the ratio of lipocalin-to-total protein concentration in tears.
Methods
A prospective study was performed on 24 eyes of patients with DES and 24 eyes of control subjects. Artificial eye drops were applied a total of eight times (15-minutes intervals) to all participants. The concentrations of total protein and lipocalin in tears were analyzed before, and after one, two, four, and eight applications. The ratio of lipocalin-to-total protein concentration was also analyzed.
Results
Total tear potein concentration of 3.35 mg/mL had decreased to 3.16 mg/mL after use of artificial tears for control while it had decreased from 1.53 to 0.87 mg/mL for patients. Both groups showed significant decrease (p = 0.04, p < 0.01, respectively). Lipocalin concentration also showed significant decreases in both control and DES patients for all applications (from 1.15 to 0.85 mg/mL for control, and from 0.49 to 0.22 mg/mL for DES patients, both, p < 0.01). The change in the ratio of lipocalin-to-total protein concentration was significant in the control group (p = 0.03) but not in the patient group (p = 0.21).
Conclusions
A significant decrease was observed in the concentrations of total protein and lipocalin in the DES patient group. The ratio of lipocalin-to-total protein concentration was also significantly decreased when eye drops were applied four times. These results suggested that the frequent use of artificial eye drops exacerbated DES.
Figures and Tables
 | Figure 1Lineal graph of total tear protein concentration for comparison between two groups of control and dry eye group. Standard errors of measurement are indicated by error bars.*Mann-Whiteny U-test (p < 0.001).
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 | Figure 2Lineal graph of tear lipoclain concentration for comparison between two groups of control and dry eye group. Standard errors of measurement are indicated by error bars. *Mann-Whiteny U-test (p < 0.001).
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 | Figure 3Lineal graph of tear lipoclain concentration per total tear protein concentration for comparison between two groups of control and dry eye group.
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