The effect of hydroxypropyl guar-hyaluronic acid (HPG-HA) dual-polymer eyedrops on inflammatory cytokine expression in tears of patients with computer vision syndrome

Purpose: To examine the impact of hydroxypropyl guar-hyaluronic acid (HPG-HA) dual-polymer eyedrops on inflammatory cytokines in the tears of individuals experiencing computer vision syndrome. Methods : A randomized, double-masked, multi-center interventional study was conducted. One hundred sixteen computer users with symptoms (using computers over 3 hours daily for at least 1 year) were randomized into two groups; 56 patients recei ved HPG-HA eyedrops, and 60 patients received preserved saline drops, both twice daily for duration of 3 months. The primary outcome was the reduction of inflammatory cytokines (IL-1β, IL2, IL4, IL5, IL6, IL8, IL10, IF-γ, TNF-α) in conjunctiva and tears of computer users. Secondary outcomes encompassed alterations in dry eye symptom scores, Schirmer test results, TBUT values, and Nelson grade at the 3-month mark. Results : At baseline, tear inflammatory cytokines and tear film parameters were similar in both the supplement and placebo groups. Tear inflammatory cytokine levels showed no significant changes from baseline at three months post-intervention in the tear supplement group, despite numerical reduction. However, the tear supplement group demonstrated a notable improvement in dry eye symptoms (P < 0.001), Schirmer test scores (P < 0.001), and TBUT scores (P < 0.001); however, there was no significant alteration in goblet cell counts or morphology og conjunctival epithelial cells. Conclusion : Treatment with hydroxypropyl guar-hyaluronic acid (HPG-HA) dual-polymer eyedrops for 3 months does alleviates dry eye symptoms and decreases tear evaporation rate in patients with computer vision syndrome. However, it does not alter tear inflammatory cytokines nor increase conjunctival goblet cell density.