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Trial registered on ANZCTR
Registration number
ACTRN12625000294459
Ethics application status
Approved
Date submitted
4/04/2025
Date registered
14/04/2025
Date last updated
15/06/2025
Date data sharing statement initially provided
14/04/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparative efficacy of artificial tears in the management of dry eye disease
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Scientific title
Comparative efficacy of artificial tears in the management of dry eye disease
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Secondary ID [1]
314001
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None
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Universal Trial Number (UTN)
U1111-1321-0438
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Dry eye disease
336804
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Condition category
Condition code
Eye
333297
333297
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0
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Diseases / disorders of the eye
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Hylo Forte, Novatears, and Systane Complete preservative-free artificial tear drops will be the interventions used in this clinical trial. Each has different properties to provide either an aqueous or lipid-based supplementation to the ocular surface.
Hylo Forte artificial tears contain 2 mg/mL of sodium hyaluronate as the active ingredient and citric acid, sodium citrate dihydrate, and sorbitol as the inactive ingredients. NovaTears is a lipid-based artificial tear formulated from perfluorohexyloctane. Systane Complete contains propylene glycol, boric acid, dimyristoyl phosphatidylglycerol, edetate disodium, hydroxypropyl guar, mineral oil, polyoxyl 40 stearate, sorbitan tristearate, and sorbitol. All participants will receive each intervention for three months. Participants will be randomly assigned to start one of the three interventions: Hylo Forte, Systane Complete or Novatears. They will be instructed to apply the assigned eye drops to both eyes four times a day for three months. After a two-week washout period to minimise carry-over effects, they will be crossed over, and each participant will proceed to the next assigned intervention. Participants will have a total of nine visits, with three visits scheduled during each treatment period: at baseline, one month, and three months. Participants will be provided with a physical diary to record details of artificial tear administration. The diary will include sections on the date and time of administration, the number of drops instilled, missed doses, symptoms or side effects, and any additional comments..
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Intervention code [1]
330637
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Treatment: Devices
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Comparator / control treatment
The participants will act as their own controls as the trial is cross-over. Hylo Forte, an aqueous-based artificial tear, will be the reference comparator.
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Control group
Active
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Outcomes
Primary outcome [1]
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Ocular Surface Disease Index score (OSDI score)
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Assessment method [1]
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The participants will be provided with a validated 12-item OSDI questionnaire designed to assess dry eye disease-related symptoms and its impact on the patient's quality of life.
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Timepoint [1]
340873
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Baseline, one month, and three months (primary endpoint) post-commencement of intervention.
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Secondary outcome [1]
446033
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Lipid layer thickness
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Assessment method [1]
446033
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It will be evaluated using a Lipiview interferometer.
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Timepoint [1]
446033
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Baseline, one month, and three months post-commencement of intervention
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Secondary outcome [2]
446036
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MMP-9 Inflammatory biomarker
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Assessment method [2]
446036
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MMP-9 marker will be analysed using enzyme-linked immunosorbent assay from the tear samples.
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Timepoint [2]
446036
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Baseline, one month, and three months post-commencemnt of intervention
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Secondary outcome [3]
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Noninvasive tear break up time (NITBUT)
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Assessment method [3]
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Noninvasive tear break up time will be assessed with an Oculus Keratograph.
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Timepoint [3]
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Baseline, one month, three months post-commencement of intervention
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Secondary outcome [4]
446037
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IL-6 inflammatory biomarker
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Assessment method [4]
446037
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IL-6 cytokine marker will be analysed using enzyme-linked immunosorbent assay from the tear samples.
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Timepoint [4]
446037
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Baseline, one month, and three months post-commencemnt of intervention
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Secondary outcome [5]
446034
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Ocular surface staining
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Assessment method [5]
446034
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It will be evaluated using fluorescein and lissamine green dye on slit lamp biomicroscopy.
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Timepoint [5]
446034
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Baseline, one month, and three months post-commencemnt of intervention.
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Secondary outcome [6]
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Corneal immune cell dynamics
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Assessment method [6]
446039
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Corneal immune cell dynamics will be evaluated with In Vivo Confocal Microscope.
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Timepoint [6]
446039
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Baseline, one month, and three months post-commencemnt of intervention
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Eligibility
Key inclusion criteria
Age of 18 years and above
Have signs and symptoms of dry eye disease
Willing to use commercially available artificial tears
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Active ocular infection, contact lens usage, intense pulse light therapy within 6 months, ocular surgery and trauma within three months, history of epilepsy or seizures, pregnancy or a plan to become pregnant within one year, and known hypersensitivity for components of Hylo Forte, Systane Complete, Novatears, fluorescein, and lissamine green dye will be excluded from the study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Active concealment will be done by removing the product label and applying an identifier code for each artificial tear bottle.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence randomisation will be used to allocate participants for each intervention.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The data will be analysed by using Statistical Package for the Social Sciences (SPSS).
Primary analysis will be undertaken using ANOVA with factors of visits and treatment groups. Categorical data will be presented in frequency and percentage. Assumptions of normal distribution and constant variance will be verified. If necessary, data transformation will be carried out.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/07/2025
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
66
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
27669
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School of Optometry and Vision Science - Kensington
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Recruitment postcode(s) [1]
43844
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2033 - Kensington
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Funding & Sponsors
Funding source category [1]
318507
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University
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Name [1]
318507
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University of New South Wales
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Address [1]
318507
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Country [1]
318507
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Australia
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Primary sponsor type
University
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Name
University of New South Wales
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Address
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Country
Australia
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Secondary sponsor category [1]
320896
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None
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Name [1]
320896
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Address [1]
320896
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Country [1]
320896
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
317112
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The University of New South Wales Committee C
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Ethics committee address [1]
317112
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https://research.unsw.edu.au/research-ethics-and-compliance-support-recs
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Ethics committee country [1]
317112
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Australia
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Date submitted for ethics approval [1]
317112
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27/02/2025
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Approval date [1]
317112
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24/04/2025
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Ethics approval number [1]
317112
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iRECS8260
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Summary
Brief summary
Artificial tear supplementation is the mainstay of treatment for dry eye disease, designed to mimic natural tears and improve the stability and properties of the tear film. Aqueous-based and lipid-containing artificial tears are the most used formulations for the treatment of dry eye, primarily due to their rapid ability to alleviate symptoms. However, there is a lack of evidence for selecting artificial tears tailored to specific dry eye disease subtypes. This study aims to investigate the comparative efficacy of aqueous and lipid-based artificial tears in improving symptoms, clinical signs, inflammatory biomarkers, and corneal immune cell dynamics of various dry eye disease subtypes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Maria Markoulli
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Address
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School of Optometry and Vision Science, University of New South Wales Level 3 North Wing Rupert Myers Building, Gate 14 Barker Street, UNSW Sydney NSW 2052 Australia
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Country
140034
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Australia
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Phone
140034
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+612 9065 7355
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Fax
140034
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Email
140034
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[email protected]
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Contact person for public queries
Name
140035
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Abel Sinshaw Assem
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Address
140035
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School of Optometry and Vision Science, University of New South Wales Level 3 North Wing Rupert Myers Building, Gate 14 Barker Street, UNSW Sydney NSW 2052 Australia
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Country
140035
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Australia
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Phone
140035
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+61400922529
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Fax
140035
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Email
140035
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[email protected]
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Contact person for scientific queries
Name
140036
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Abel Sinshaw Assem
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Address
140036
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School of Optometry and Vision Science, University of New South Wales Level 3 North Wing Rupert Myers Building, Gate 14 Barker Street, UNSW Sydney NSW 2052 Australia
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Country
140036
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Australia
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Phone
140036
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+61400922529
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Fax
140036
0
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Email
140036
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Type
Citation
Link
Email
Other Details
Attachment
Study protocol
Clinical Trial Protocol_Artificial tear.docx
Informed consent form
PISCF.docx
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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