Effect of Preserved Versus Preservative-Free Artificial Tears on the Corneal Epithelial Thickness Mapping by MS-39 in Dry Eye Patients

Q: How were treatments assigned to patients?

Preserved artificial tears were given to the left eye (group A) and preservative-free artificial tears to the right eye (group B), with assessments before and 3 months after treatment.

Q: What were the key findings regarding corneal epithelial thickness and symptoms?

Both groups showed increased epithelial thickness mapped by MS-39 and improvement in OSDI, but the preservative-free group demonstrated superior improvements in OSDI and post-treatment epithelial thickness in specific corneal regions.

Sep 30, 2026

Uploaded by Alex Sinclair

Compares clinical outcomes and corneal epithelial thickness mapping using MS-39 in dry eye disease patients treated with preserved versus preservative-free artificial tears. A prospective interventional comparative study enrolled 44 patients (88 eyes), assigning preserved drops to the left eye and preservative-free drops to the right eye. Dry eye parameters and epithelial thickness were assessed before treatment and at 3 months, evaluating measures including NIBUT and OSDI.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Purpose

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Results

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Introduction

Materials and Methods

Wiley Journal of Ophthalmology Volume 2026, Article ID 9923353, 9 pages [https://doi.org/10.1155/joph/9923353](https://doi.org/10.1155/joph/9923353) Research Article Effect of Preserved Versus Preservative-Free Artificial Tears on the Corneal Epithelial Thickness Mapping by MS-39 in Dry Eye Patients Ghada A. Nassar , 1 Ahmed Rashad Ashor , 1 Mohamed Hosny , 1 Jorge Alio 2 , and Aliaa A. Farag 1 1 Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt 2 Department of Ophthalmology, University Miguel Hernandez, Alicante, Spain Correspondence should be addressed to Aliaa A. Farag; [aliaaa.farag@gmail.com](aliaaa.farag@gmail.com) Received 10 October 2024; Revised 11 December 2025; Accepted 15 December 2025 Academic Editor: Karuna Sharma Copyright © 2026 Ghada A. Nassar et al. Journal of Ophthalmology published by John Wiley & Sons Ltd. Tis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Purpose: To compare clinical and corneal epithelial changes between preservative and preservative-free artifcial tear therapy using the MS-39 in patients with dry eye disease (DED) . Methods: Tis prospective interventional comparative study included 88 eyes of 44 patients. Preserved artifcial tears were given for the left eye (group A) and preservative-free artifcial tears for the right eye (group B) . Tey were evaluated before and 3 months after treatment using MS-39 . Te dry eye parameters and corneal epithelial thickness were recorded. Results: Tere was an increase in the NIBUT and improvement in the severity by OSDI score (p-value < 0.001) in each group. Tere was no signifcant diference in the mean NIBUT between the two groups (p-value 􀂈 0.470) . Improvement in the OSDI score (p-value 􀂈 0.026) and mean post-treatment epithelial thickness in the central, paracentral superior, and peripheral inferior epithelial areas were signifcant in the preservative-free group than the preservative one (p-value 􀂈 0.033, 0.034, and 0.023, respectively) . Conclusion: Although both preservative-free and preserved artifcial tears show an increase in epithelial thickness using MS-39 and improvement in OSDI, preservative-free artifcial tears show superiority, subjectively and objectively, compared to preserved artifcial tears using even lighter preservatives, being a safer option for long-term application. Keywords: corneal epithelial thickness; dry eye disease; MS-39; preservative-free artifcial tears; preserved artifcial tears 1. Introduction Dry eye disease (DED) is a multifactorial pathology that leads to ocular surface infammation, tear flm instability, and tear hyperosmolarity. Infammation causes injury to the conjunctival and corneal epithelial cells. Damage to corneal epithelium and nerves may cause symptoms of DED, such as ocular discomfort, dryness, and visual disturbance [1–4] . Te diagnosis of DED is based on multiple tests, including the subjective symptoms, visual acuity, tear break-up time (TBUT), tear osmolarity, tear volume, tear flm composition, kerato-conjunctival vital staining, and ocular biomarkers [5, 6] . Anterior segment optical coherence tomography (ASOCT) is a noninvasive imaging method with high-resolution analysis. AS-OCT has been preferred in several studies for evaluating corneal epithelium because of its great reliability and repeatability [7, 8] . Owing to the importance of epithelial thickness in the modern evolution of the cornea, diferent studies have evaluated the epithelial thickness mapping as a valuable marker in the diagnosis, management, and follow-up of the 2 Journal of Ophthalmology regenerative process of the corneal epithelial profle in diferent diseases [9–11] . MS-39, a unique high-defnition spectral domain ASOCT, is a standalone device that uses SD-OCT and Placidodisk corneal topography to ob

FAQs

What is the main objective of the study?

To compare clinical and corneal epithelial changes between preserved and preservative-free artificial tear therapy using MS-39 in patients with dry eye disease.

How were treatments assigned to patients?

Preserved artificial tears were given to the left eye (group A) and preservative-free artificial tears to the right eye (group B), with assessments before and 3 months after treatment.

What were the key findings regarding corneal epithelial thickness and symptoms?

Both groups showed increased epithelial thickness mapped by MS-39 and improvement in OSDI, but the preservative-free group demonstrated superior improvements in OSDI and post-treatment epithelial thickness in specific corneal regions.

Sep 30, 2026

Uploaded by Alex Sinclair