Hypochlorous acid hygiene solution in patients affected by blepharitis: a prospective randomised study

Area of Science:

• Ophthalmology
• Microbiology

Background:

• Blepharitis is a common condition often associated with dry eye disease (DED).
• Effective management of blepharitis is crucial for improving DED symptoms.
• Antimicrobial and anti-inflammatory treatments are key in blepharitis management.

Purpose of the Study:

• To compare the clinical outcomes and antimicrobial efficacy of hypochlorous acid (HOCl) hygiene solution versus hyaluronic acid (HYAL) wipes for blepharitis treatment in DED patients.
• To evaluate the impact of HOCl and HYAL on various ocular surface parameters and bacterial load.

Main Methods:

• A 4-week randomized study involving 48 patients with blepharitis and mild to moderate DED.
• Patients were treated with either HOCl solution (24 eyes) or HYAL wipes (24 eyes).
• Clinical outcomes including tear film stability (NIK-BUT, TF-BUT), tear meniscus height (TMH), meibography, MGYSS, CSS, Schirmer test, conjunctival redness, and OSDI were assessed. Microbiological analysis of eyelid margins was also performed.

Main Results:

• HOCl group showed significant improvements in non-invasive keratograph break up time (NIK-BUT) and tear film break up time (TF-BUT), unlike the HYAL group.
• Both groups showed improvements in OSDI, TMH, and MGYSS, but HOCl demonstrated a more pronounced reduction in bacterial load.
• No significant changes were observed in Schirmer test, meibography, CSS, or conjunctival redness in either group.

Conclusions:

• Hypochlorous acid (HOCl) hygiene solution is a safe and effective treatment for blepharitis in DED patients.
• HOCl demonstrates superior clinical outcomes and antimicrobial activity compared to hyaluronic acid wipes.
• HOCl offers a promising therapeutic option for managing blepharitis and improving ocular surface health.