To evaluate the clinical efficacy of topical diquafosol tetrasodium 3% ophthalmic solution in patients with short tear film break-up time (BUT) dry eye.

This prospective study involved 30 eyes in 30 patients with dry eye who had tear film BUT values ≤5 seconds and schirmer's 1 test ≥5 mm, and showed no improvement with non-preservative sodium hyaluronate (SH) 0.1% artificial tears. All patients were treated with topical diquafosol tetrasodium 3% 6 times a day, in addition to SH 0.1% artificial tears. Schirmer's 1 test, tear film BUT, keratoepitheliopathy score with fluorescein, conjunctival staining score with lissamine green, and Ocular surface disease index (OSDI) score were evaluated at before treatments, and 1 month and 3 months after treatments.

Significant improvements of tear film BUT and OSDI were observed at 1 month and 3 months after diquafosol tetrasodium 3% administration. At before treatment, and followed up at 1 and 3 months, tear film BUTs were 3.3 ± 1.2, 4.4 ± 1.0 ( p < 0.01) and 4.9 ± 1.1 seconds ( p < 0.01), respectively, and OSDI scores were 43.5 ± 24.4, 34.6 ± 25.0 ( p = 0.01) and 26.7 ± 21.5 ( p < 0.01), respectively. There were no significant changes of Schirmer's score, keratoepitheliopathy, and conjunctival staining score. After diquafosol tetrasodium 3% administration, severe adverse effects were not found in any of the patients.

Topical diquafosol tetrasodium 3% administration was shown to be an effective treatment for improvements of tear film stability and dry eye symptoms.