Evidence map›Paper›PMID 40679590›Full record

SynthesisNaunyn-Schmiedeberg's archives of pharmacology2026

Which topical ophthalmic drugs work best for Keratoconjunctivitis Sicca? A systematic review and meta-analysis.

Kai-Yang Chen, Hoi-Chun Chan, Chi-Ming Chan

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Naunyn-Schmiedeberg's archives of pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Kai-Yang ChenSchool of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Hoi-Chun ChanSchool of Pharmacy, China Medical University, Taichung, Taiwan.
Chi-Ming ChanDepartment of Ophthalmology, Cardinal Tien Hospital, New Taipei City, Taiwan. m212092001@tmu.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDry Eye Disease (DED) is a chronic and multifactorial condition that significantly impacts patient quality of life. Topical ophthalmic drugs (TODs) have emerged as key treatments for DED, offering the potential to address the underlying pathology rather than merely alleviating symptoms. This review aims to assess the efficacy of various TODs in managing the symptoms of DED.

methodsA comprehensive search was conducted across three electronic databases to identify relevant articles for inclusion in this review. Two independent authors screened the articles according to predefined eligibility criteria. A total of 16 randomized controlled trials (RCTs) were included, summarizing data from 2,680 patients. The data were analyzed using Review Manager 5.4, with pooled analysis conducted on key symptoms including corneal fluorescein staining (CFS), Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), and Schirmer test scores.

resultsFrom 632 articles identified, 16 RCTs were selected for inclusion. The pooled analysis revealed that cyclosporine therapy resulted in a significant improvement in CFS scores (mean difference (MD) -0.24; 95% confidence interval (CI) (-0.42, -0.07), P = 0.006). However, no significant improvements were observed in OSDI, TBUT, or Schirmer test scores (MD -0.35; 95% CI (-5.66, 4.96), P = 0.9; MD 0.12; 95% CI (-0.65, 0.89), P = 0.76; MD -0.22; 95% CI (-0.46, 0.02), P = 0.07, respectively). Similar results were found for loteprednol etabonate (LE) and diquafosol sodium, with no significant changes in OSDI, CFS, or Schirmer test scores. For diquafosol, no significant improvements were observed in any of the DED symptoms, including OSDI (MD -3.82; 95% CI (-8.31, 0.67), P = 0.10), CFS (MD -0.31; 95% CI (-0.82, 0.20), P = 0.23), TBUT (MD -0.20; 95% CI (-1.37, 0.98), P = 0.74), and Schirmer test (MD -1.00; 95% CI (-2.60, 0.60), P = 0.22).

conclusionThe study concluded that cyclosporine therapy offers improvements in corneal fluorescein staining but does not significantly affect other common DED symptoms, such as OSDI, TBUT, and Schirmer test scores. Similarly, no significant improvements in DED symptoms were observed with loteprednol etabonate or diquafosol sodium. Further research is needed to explore the efficacy of these treatments in managing DED symptoms more comprehensively.

Indexed as

Keratoconjunctivitis SiccaOphthalmic SolutionsAdministration, OphthalmicAdministration, TopicalCyclosporineHumansRandomized Controlled Trials as TopicCyclosporineOphthalmic SolutionsDry eye diseaseKeratoconjunctivitis SiccaMeta-analysisTopical ophthalmic drugs

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.