The present study was performed to evaluate the changes in tear film and ocular surface parameters after using sodium hyaluronate (SH) 0.1% alone or in combination with cyclosporine A (CsA) 0.05% in patients with thyroid-associated ophthalmopathy accompanied by dry eye.

A total of 72 eyes from 36 patients were divided into two groups; 36 eyes of 18 patients were treated with 0.1% SH alone (group 1), and 36 eyes of 18 patients were treated with SH 0.1% and CsA 0.05% (group 2). Tear break-up time (BUT), basal tear secretion test (BST), tear clearance rate (TCR), fluorescein staining (FS) and corneal sensitivity test (CST) were evaluated at pre-treatment and one, three and six months post-treatment. Conjunctival impression cytology was performed and tear CXCL11 (Chemokine (C-X-C motif) ligand) levels were measured pre-treatment and three months post-treatment.

BUT, BST, TCR, KEP and CST were significantly improved at six months in group 1 ( p < 0.05) and at three months in group 2 ( p < 0.05). The degree of conjunctival squamous cell metaplasia, goblet cell density and tear CXCL11 levels were significantly changed at three months in group 2 ( p < 0.05). However, there were no significant changes in group 1 after 3 months.

Combined use of topical 0.1% SH and 0.05% CsA can result in early improvement in tear films and ocular surface parameters in patients with thyroid-associated ophthalmopathy accompanied by dry eye.