Stimulation of tear secretion and treatment of dry-eye disease with 3-isobutyl-1-methylxanthine
J. P. Gilbard, S. R. Rossi, K. G. Heyda and D. A. Dartt
Eye Research Institute, Harvard Medical School, Boston, MA 02114.
We examined the effect of topically applied 3-isobutyl-1-methylxanthine
(IBMX), a known secretagogue, on tear secretion and dry-eye disease in a
clinical study. We found that IBMX produced a dose-dependent decrease in
tear film osmolarity that was significant at 3.0 mmol/L (P less than .0005)
in patients with dry-eye disease. This effect was not blocked by prior
administration of proparacaine hydrochloride (P less than .05). Throughout
a 4-week, open-label, vehicle-controlled study, IBMX decreased tear film
osmolarity significantly, whereas vehicle alone did not. After 4 weeks,
mean (+/- SEM) osmolarity in IBMX-treated eyes decreased from 325 +/- 3.2
mOsm/L to 312 +/- 1.8 mOsm/L but remained unchanged in vehicle-treated eyes
(323 +/- 4.4 mOsm/L vs 320 +/- 4.2 mOsm/L). In our study, IBMX was
significantly more effective than vehicle alone in decreasing rose bengal
staining (P less than .02). Hence, topical IBMX stimulated tear secretion
and decreased ocular surface disease in patients with dry-eye disease.
