Immediate Impact of Artificial Tear Composition on Optical Aberrations: A Comparative Study of Lipid and Non-Lipid Hydroxypropyl Guar Formulations

• Published in: Ophthalmology and therapy Vol. 14; no. 9; pp. 2165 - 2178
• Main Authors: Sánchez-González, José-María, Sánchez-González, María Carmen, De-Hita-Cantalejo, Concepción, Nascimento, Henrique, Martinez-Perez, Clara
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.09.2025; Springer Nature B.V; Adis, Springer Healthcare
• Subjects: Astigmatism; Clinical trials; Cornea; Hyaluronic acid; Hydration; Hydroxypropyl guar; Internal Medicine; Laboratories; Lipid eye drops; Lipids; Medicine; Medicine & Public Health; Mineral oil; Mineral oils; Non-lipid eye drops; Ocular aberrations; Ophthalmology; Original Research; Viscosity; Fort Worth Texas; United States > US; Texas; Hydroxypropyl guar; Mineral oil; Hyaluronic acid; Ocular aberrations; Non-lipid eye drops; Lipid eye drops
• ISSN: 2193-8245; 2193-6528
• DOI: 10.1007/s40123-025-01205-z

Introduction To evaluate the immediate effects of two artificial tear formulations—mineral oil + hydroxypropyl guar (HP-Guar) and hyaluronic acid (HA) + HP-Guar—on ocular aberrations in healthy participants. Methods A randomized, participant-masked clinical trial was conducted on 98 right eyes of 98 participants (mean age: 27.96 ± 10.00 years). Participants received a single instillation of either a lipid-based (mineral oil + HP-Guar) or non-lipid (HA + HP-Guar) artificial tear solution. Ocular aberrations were measured before and 10 min post-instillation using a wavefront aberrometer (i.Profilerplus ® , Carl Zeiss Meditec, Jena, Germany) at pupil diameters of 3 mm and 5 mm. Root mean square (RMS) values for total, low-order, and high-order aberrations were analyzed. Results The mineral oil + HP-Guar formulation significantly reduced total RMS ( p  < 0.05) and low-order RMS ( p  < 0.05) at both 3-mm and 5-mm pupil diameters. Notable reductions were observed in defocus ( Z 2 0 ), vertical astigmatism ( Z 2 2 ), and trefoil ( Z 3 −3 ). Both formulations significantly increased high-order RMS ( p  < 0.05). Conclusions Lipid-based artificial tears provide superior optical quality by reducing total and low-order ocular aberrations, making them preferable for patients with tear film instability. In contrast, HA-based formulations primarily improve hydration with limited impact on optical performance. Artificial tear selection should consider both symptomatic relief and refractive stability, especially for individuals with high visual demands. Clinical Trial Registration This study was registered as a randomized clinical trial on ClinicalTrials.gov under the identifier NCT06784661, titled the ILEACT study.