1. Efficacy and safety of trigeminal parasympathetic pathway stimulation for dry eye: A systematic review and meta-analysis
- Author
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Hu, Jindong, Ju, Mohan, Shi, Yongjun, Liu, Xinquan, and Zhu, Yongbao
- Subjects
Dry eye syndromes -- Diagnosis -- Care and treatment ,Clinical trials -- Evaluation ,Lacrimal organs -- Health aspects - Abstract
This study aimed to investigate the efficacy and safety of trigeminal parasympathetic pathway (TPP) stimulation in the treatment of dry eye. A comprehensive search for randomized clinical trials was performed in seven databases (MEDLINE, Embase, CENTRAL, etc.) up to 28 February 2023. After screening the suitable studies, the data were extracted and transformed as necessary. Data synthesis and analysis were performed using Review Manager 5.4, and the risk of bias and quality of evidence were evaluated with the recommended tools. Fourteen studies enrolling 1714 patients with two methods (electrical and chemical) of TPP stimulation were included. Overall findings indicate that TPP stimulation was effective in reducing subjective symptom score (standardized mean difference [SMD], -0.45; 95% confidence interval [CI], -0.63 to -0.28), corneal fluorescence staining (mean difference [MD], -0.78; 95% CI, -1.39 to -0.18), goblet cell area (MD, -32.10; 95% CI, -54.58 to -9.62) and perimeter (MD, -5.90; 95% CI, -10.27 to -1.53), and increasing Schirmers test score (SMD, 0.98; 95% CI, 0.65 to 1.31) and tear film break-up time (SMD, 0.57; 95% CI, 0.19 to 0.95). Compared to inactive or low-activity stimulation controls, it has a higher incidence of adverse events. Therefore, TPP stimulation may be an effective treatment for dry eye, whether electrical or chemical. Adverse events are relatively mild and tolerable. Due to the high heterogeneity and low level of evidence, the current conclusions require to be further verified. Keywords: Dry eye, neuromodulation, neurostimulation, trigeminal parasympathetic pathway, Author(s): Jindong Hu (corresponding author) [1,2]; Mohan Ju [3]; Yongjun Shi [4]; Xinquan Liu [5]; Yongbao Zhu (corresponding author) [6] Dry eye is a multifactorial disease of the ocular surface[sup.[1]] [...]
- Published
- 2024
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