The effect of topical F.A.G. ®, Tobramycin and 0.15% Hyaluronate eye drops on keratocongiunctivitis sicca

Keratoconjunctivitis sicca (KCS) is a common ocular disease in the dog and is the most commonly recognized form of dry eye disease (DED) in this species. Topical antinflammatory and immunomodulatory therapy has become the significant way of treating KCS in dogs. However, as the long-term use of routine anti-inflammatory medications is restricted from their side effects, it is inevitable to explore safer and more effective alternatives. Essential fatty acids have proven to be anti-inflammatory systemically, which makes it possible to treat dry eye. Clinical trials have demonstrated that supplementation with either ω-3 or ω-6 essential fatty acids or both has multifactorial efficacies including improvement of subjective symptoms, alleviation of inflammation of ocular surface and eyelid margin, prolongation of tear break-up time and increase of tear flow secretion [1-3]. The aim of this study was to evaluate the efficacy of a periophtalmic cream of a pool of Fatty Acid Group (F.A.G.®) in association with topical tobramycin and 0.15% hyaluronate eye drops in alleviating the clinical symptoms of canine KCS. The clinical study was conducted on 10 dogs diagnosed with idiopathic KCS. The dogs were of various breeds and had been pretreated unsuccessfully only with topical antibiotics. The affected eyes were treated with two applications daily of a periophtalmic cream of a pool of fatty Acid Group (FAG®), one drop three times a day of tobramycin, and one drop three times a day of 0.15% of hyaluronate eye drops. Ophthalmic examination included direct and indirect ophthalmoscopy, slit lamp examination, Schirmer tear test I (STT I) and measurement of intraocular pressure (IOP) with the applanation tonometer. Diagnosis and severity of KCS were evaluated by STT and by assessment of ocular discharge, conjunctival inflammation, corneal inflammatory cell infiltrate and scarring, and degree of ocular discomfort. Clinical and ophthalmologic examinations were performed prior to the treatment as well as after two and eight weeks of therapy. The effect of treatment was pronounced (increase in STT values to higher than 4 mm/min, no signs of inflammation) in 8/18 eyes; moderate (increase in STT values of 3–4 mm/min, mild signs of corneal/conjunctival inflammation) in 3/18 eyes; unsatisfactory in 7 of 18 eyes. No side effects were observed in any case. Results of this exploratory study suggest that association with topical FAG, tobramycin and 0.15% hyaluronate eye drops may be a safe and effective treatment for keratoconjunctivitis sicca in dogs; however, in moderate and advanced stages, efficacy in obtaining reduction of neovascularization or corneal pigmentation was not observed across the treatment period.