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May 1991

Stimulation of Tear Secretion and Treatment of Dry-Eye Disease With 3-Isobutyl-1-methylxanthine

Author Affiliations

From the Cornea Unit of the Eye Research Institute (Drs Gilbard and Dartt, Mr Rossi, and Ms Gray Heyda) and the Department of Ophthalmology (Drs Gilbard and Dartt), Harvard Medical School, Boston, Mass.

Arch Ophthalmol. 1991;109(5):672-676. doi:10.1001/archopht.1991.01080050086035

• 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<.0005) in patients with dry-eye disease. This effect was not blocked by prior administration of proparacaine hydrochloride (P<.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<.02). Hence, topical IBMX stimulated tear secretion and decreased ocular surface disease in patients with dry-eye disease.

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