Effect of Hypochlorous Acid on Blepharitis through Ultrasonic Atomization: A Randomized Clinical Trial

Author:

Zhang Hong12,Wu Yuqing2,Wan Xichen2,Shen Yan2,Le Qihua2,Yang Pei2,Zhou Shuyun2,Zhou Xujiao2,Zhou Feng3,Gu Hao1,Hong Jiaxu12

Affiliation:

1. Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China

2. Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai 200437, China

3. Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China

Abstract

Purpose: To evaluate the efficacy and safety of eyelid hygiene using topical 0.01% hypochlorous acid (HOCL) through ultrasonic atomization after 2 weeks in patients with blepharitis. Design: Randomized controlled trial. Methods: Patients with blepharitis were randomized into two groups: topical 0.01% HOCL through ultrasonic atomization (HOCL group, 42 eyes) or eyelid scrubs (control group, 37 eyes). Patients in both groups received warm compresses twice daily and topical 0.5% levofloxacin three times a day. Primary outcomes were the ocular surface disease index scores (OSDI), lid margin redness, lid margin abnormalities, meibum expressibility, meibum quality, and noninvasive breakup time after 2 weeks. Secondary outcomes were conjunctiva redness, corneal fluorescein staining, and tear meniscus height. A questionnaire of treatment adherence with a free response section was administered to confirm patient compliance and comments. Results: Sixty-seven participants participated in this study. Both groups show an improvement in all primary outcomes, while statistically significant improvements in OSDI, lid margin redness, lid margin abnormality, meibum expressibility and quality are only limited to the HOCL group after 2 weeks of treatment (p < 0.05, p < 0.05, p < 0.001, p < 0.001 and p < 0.001, respectively). Subgroup analysis in HOCL reveals that only the change in lid margin abnormality and meibum expressibility in the mild–moderate meibomian glands loss patients at baseline has a statistically significant difference p < 0.05). Multiple linear regression shows that the improvement in OSDI is negatively associated with meibum expressibility score at the baseline (95% CI [−28.846, −1.815], p = 0.028). The patient compliance is 7.1 ± 2.0 in the HOCL group and 7.1 ± 1.8 in the control group (p > 0.05). No adverse events are reported. Conclusion: Topical 0.01% HOCL through ultrasonic atomization is a tolerable and effective eyelid hygiene treatment for blepharitis.

Funder

National Natural Science Foundation of China

Shanghai Medical Innovation Research Program

Shanghai Key Clinical Research Program

Publisher

MDPI AG

Subject

General Medicine

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