Mallow extract-containing hyaluronic (HA) acid eye drops for the treatment of dry eyes is perceived superior over an HA-only product

Dry eye syndrome is caused by insufficient lubrication of the cornea. Extensive screen time, wearing contact lenses or staying in an air-conditioned environment are frequent triggers for dry eye symptoms

In an observational clinical phase IV study the comparative efficacy of Visiodoron Malva^® (0.15% hyaluronic acid (HA) plus 0.5% mallow extract, HA+M) or a competitive HA-only product (0.15% HA, HA) was investigated. The following parameters were recorded: subjective efficacy, individual patients` preference, tear film breakup times (TBUT), lissamine green staining of the cornea, symptoms grade, Schirmer test, ocular surface disease index (OSDI). Furthermore, physical properties (viscosity/surface tension) of the eye drops with and w/o mallow extract were analyzed.

With HA+M in 90% of the patients OSDI improved from ‘moderate’ to ‘mild’/‘normal’, whereas with the competitor w/o mallow extract, this rate was only 60%. No difference was shown for TBUT, lissamine green staining, symptoms or Schirmer test. However, subjective efficacy perceived by patients and the patients’ preference was superior for HA+M.

Rheology of eye drops is negatively influenced by HA concentration as evidenced by concentration-dependent increase of viscosity. Notably, in HA-containing eye drops plus mallow extract surface tension was significantly reduced. Reduction of surface tension and thereby prevention of tear film break-ups represents an important physiological mechanism provided by surfactant proteins in tears. Although there was no difference in lubrication between the two treatments, HA plus mallow extract is perceived superior by patients over an HA-only product. This superiority might be mediated by the reduced surface tension caused by mallow extract.