Artificial Tear Improves Dry Eye Symptoms in Women, Peri and Postmenopausal

An artificial tear containing containing trehalose and hyaluronic acid may improve dry symptoms in women older than 40 years.

An artificial tear containing trehalose and hyaluronic acid can improve dry eye disease (DED) symptoms in women who are perimenopausal (aged 42-54 years) or postmenopausal (older than 55 years), according to a post hoc analysis of 3 clinical trials published in Contact Lens and Anterior Eye. While women of both age groups demonstrated a benefit from treatment, the report suggests that women who are perimenopausal have better mechanisms for improving after ocular inflammation compared with women who are postmenopausal.

The team enrolled 273 women who were perimenopausal (n=61) or postmenopausal (n=212) with DED determined by an Ocular Surface Disease Index (OSDI) of 18 or greater. Participants instilled 1 drop of the artificial tears, which contained trehalose (3%) and hyaluronic acid (0.15%), in each eye 3 to 6 times daily and underwent OSDI, tear breakup time (TBUT), and corneal and conjunctival staining assessments at baseline and at a mean [SD] 84 [7] days following the initial evaluation.

The researchers included participants from 2 phase 3 studies — Efficacy and Safety of T2762 and Vismed® in Dry Eye Syndrome ( identifier: NCT02023268) and Comparison of the Efficacy and Safety of T2762 Versus Optive® in the Treatment of Moderate to Severe Dry Eye Syndrome ( identifier: NCT02617095) — and an observational study — Evaluation of Ocular Surface Disease Symptoms and Patient Satisfaction with Thealoz® Duo after 84 Days of Daily Treatment ( identifier: NCT04803240) in the investigation.

Participants in both cohorts demonstrated significant decreases in OSDI scores with artificial tear treatment at the study conclusion (<.0001). Conjunctival hyperemia decreased significantly and TBUT increased significantly in both groups, but these improvements were more remarkable among women who were perimenopausal (P  <.0001), the report shows.  

Both corneal and conjunctival staining score decreased significantly following artificial tear treatment in both groups, and these changes were also more remarkable among women who were perimenopausal, according to the report.  

Overall, women who were perimenopausal reported more DED symptoms compared with the cohort of women who were postmenopausal, but the effect of the treatment tended to be more pronounced among the women who were younger.

“These results suggest that young women could have better compensation (hormetic response), recovery and cellular vitality mechanisms that allowed for improved reversibility of the ocular surface condition,” according to the study authors. “The longer evolution of the disease and the chronicity of the ocular surface inflammation could decrease the reversibility of the condition. For these reasons, additional therapeutic measures may be needed in some patients to achieve further reductions of the signs and
symptoms of DED in these patients.” 

Study limitations include a small sample size, an inability to blind participants to treatment, and a retrospective nature.

Disclosure: This research was supported by Théa Laboratoires. Please see the original reference for a full list of disclosures.


Mateo-Orobia AJ, Del Prado Sanz E, Blasco-Martínez A, Pablo-Júlvez LE, Farrant S, Chiambaretta F. Efficacy of artificial tears containing trehalose and hyaluronic acid for dry eye disease in women aged 42-54 versus ≥ 55 years. Cont Lens Anterior Eye. Published online April 26, 2023. doi:10.1016/j.clae.2023.101845