***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Purpose : To compare the efficacy and safety of 0.3 % hydroxypropyl methylcellulose/dextran ( HPMC/dextran ) and 0.18 % sodium hyaluronate ( SH ) in the treatment of ocular surface disease in patients using antiglaucoma drugs containing preservatives . Methods : This was a double-blind , r and omized , parallel-group study in 70 glaucoma patients with Ocular Surface Disease Index ( OSDI ) score greater than 20 points and /or presence of ocular signs . Patients were r and omized to receive either preservative-free 0.3 % HPMC/dextran ( n=35 ) or preservative-free 0.18 % SH ( n=35 ) . Treatment was 1 drop in each eye , 4 times a day . Data were collected at baseline , at day 7 and day 28 . Results : The groups were homogeneous at baseline . At day 28 , both treatments showed significant improvements ( P<0.05 ) in the mean OSDI score , lid skin and lid margin inflammation , conjunctival injection , and expressibility of meibomian gl and s , corneal staining score , fluorescein tear breakup time ( FBUT ) , and Schirmer I test . However , the mean OSDI score , lid margin inflammation and conjunctival injection showed significant improvements ( P<0.05 ) in the SH group at days 7 and 28 , compared to the HPMC/dextran group . FBUT and the Schirmer I test also showed significant improvements ( P<0.05 ) in the SH group compared to the HPMC/dextran group , at day 28 . No adverse reactions were observed in either group . Conclusions : Preservative-free artificial tear , 0.3 % HPMC/dextran , and 0.18 % SH , caused a significant relief of the ocular surface disease in glaucoma patients . However , 0.18 % SH led to a greater improvement in ocular signs and symptoms than 0.3 % HPMC/dextran PURPOSE Dry eye syndrome ( DES ) is believed to be one of the most common ocular problems in the United States ( US ) , particularly among older women . However , there are few studies describing the magnitude of the problem in women and how this may vary with demographic characteristics . DESIGN Cross-sectional prevalence survey . METHODS STUDY POPULATION we surveyed 39,876 US women participating in the Women 's Health Study about a history of diagnosed DES and dry eye symptoms . MAIN OUTCOME MEASURE we defined DES as the presence of clinical ly diagnosed DES or severe symptoms ( both dryness and irritation constantly or often ) . We calculated the age-specific prevalence of DES and adjusted the overall prevalence to the age distribution of women in the US population . We used logistic regression to examine associations between DES and other demographic factors . RESULTS The prevalence of DES increased with age , from 5.7 % among women < 50 years old to 9.8 % among women aged > or = 75 years old . The age-adjusted prevalence of DES was 7.8 % , or 3.23 million women aged > or = 50 in the US . Compared with Whites , Hispanic ( odds ratio [ OR ] = 1.81 , confidence interval [ CI ] = 1.18 - 2.80 ) and Asian ( OR = 1.77 , CI = 1.17 - 2.69 ) women were more likely to report severe symptoms , but not clinical ly diagnosed DES . There were no significant differences by income ( P([trend ] ) = .78 ) , but more educated women were less likely to have DES ( P([trend ] ) = .03 ) . Women from the South had the highest prevalence of DES , though the magnitude of geographic differences was modest . CONCLUSIONS Dry eye syndrome leading to a clinical diagnosis or severe symptoms is prevalent , affecting over 3.2 million American women middle-aged and older . Although the condition is more prevalent among older women , it also affects many women in their 40s and 50s . Further research is needed to better underst and DES and its impact on public health and quality of life PURPOSE The effective management of dry eye must include a clinical ly meaningful reduction in ocular staining . Evaluations of corneal and conjunctival staining and other ocular symptoms of dry eye were conducted for a new formulation of polyethylene glycol 400/propylene glycol-based lubricant eye drops containing hydroxypropyl guar as a gelling agent ( Test Product ) in comparison to Optive Lubricant Eye Drops ( Control Product ) in adult patients with dry eye . METHODS One hundred thirteen patients , 18 years of age and older , with dry eye were enrolled in a prospect i ve , double-masked , multisite , parallel-group study . After a 2-week run-in period during which patients administered aqueous saline eye drops 4 times daily ( QID ) in each eye , patients were r and omized ( 1:1 ) to receive either Test Product or Control Product to be administered QID for 6 weeks . Efficacy and safety were evaluated by corneal and conjunctival staining scores , tear film breakup time , assessment s of ocular symptoms , ocular surface disease index ( OSDI ) scores , dry eye treatment satisfaction , visual function-14 question naires , and adverse events . RESULTS The intent-to-treat data set included 105 patients r and omized to Test Product ( n = 52 ) or Control Product ( n = 53 ) . Patients primarily were between the ages of 18 - 64 years ( 70.5 % ) , female ( 73.3 % ) , white ( 93.3 % ) , and not Hispanic ( 81.9 % ) . Patients in the Test Product group exhibited significantly lower mean corneal staining scores than the Control Product group at day 14 ( P = 0.0009 ) and day 42 ( P = 0.0106 ) , and significantly lower mean conjunctival staining scores at day 28 ( P = 0.0475 ) and day 42 ( P = 0.0009 ) . Patients in both treatment groups reported significant reductions in the mean scores for the ocular symptoms of dryness , gritty/s and y feeling , and burning ( P < or= 0.0021 for all comparisons to baseline ) . Lastly , a significantly lower OSDI score than baseline was reported at day 42 by patients in both the Test Product ( P = 0.0013 ) and Control Product ( P < 0.0001 ) groups . CONCLUSIONS The results of this study indicate that the Test Product significantly reduced corneal and conjunctival staining , indicating a reduction in disease severity . Evaluations of ocular staining scores provide clinical ly meaningful evidence of dry eye severity and are an important indicator of dry eye disease progression Background The purpose of this study was to compare changes in corneal staining in patients with dry eye after 6 weeks of treatment with Systane ® Gel Drops or Refresh Liquigel ® lubricant eye drops . Methods Patients aged ≥18 years with a sodium fluorescein corneal staining sum score of ≥3 in either eye and best-corrected visual acuity of 0.6 logarithm of the minimum angle of resolution or better in each eye who were using a lubricant eye gel or ointment for dry eye were included in this r and omized , parallel-group , multicenter , double-blind trial . Patients were r and omized to four times daily Systane ® Gel Drops ( polyethylene glycol 400 0.4 % and propylene glycol 0.3 % ) or Refresh LiquiGel ® Drops ( carboxymethylcellulose sodium 1 % ) for 6 weeks . The primary efficacy outcome was mean change from baseline to week 6 in sodium fluorescein corneal staining . Supportive efficacy outcomes included conjunctival staining , tear film break-up time , Patient Global Assessment of Improvement , Impact of Dry Eye on Everyday Life ( IDEEL ) Treatment Satisfaction/Treatment Bother Question naire , Single Symptom Comfort Scale , and Ocular Symptoms Question naire . The safety analysis comprised recording of adverse events . Results In total , 147 patients ( Systane group , n=73 ; Refresh group , n=74 ; mean ± st and ard deviation age , 57±16 years ) were enrolled and included in the safety and efficacy analyses  . Corneal staining was significantly reduced from baseline to week 6 for Systane and Refresh ( −3.4±2.5 and −2.5±2.6 units , respectively ; P<0.0001 , t-test ) , with a significantly greater improvement with Systane versus Refresh ( P=0.0294 ) . Results for conjunctival staining , tear film break-up time , and patient-reported outcome question naires were not statistically different between groups . No safety issues were identified ; adverse events were reported by 19 % of patients with Systane and 30 % of patients with Refresh eye drops . Conclusion Systane Gel Drops were associated with significantly better corneal staining scores versus Refresh Liquigel eye drops in patients with dry eye . Supportive efficacy outcomes were not significantly different between groups . Both treatments were well tolerated Abstract Purpose : To evaluate the effects of different artificial tear eye drops on Ocular Surface Disease Index ( OSDI ) , tear osmolarity , Schirmer ’s I test , and tear break-up time ( TBUT ) in patients with dry eye disease . Material s and methods : This 12-week , single-institution , single-masked , r and omized , pilot study was conducted in Turkey between March and July 2012 in patients with dry eye . Patients were r and omly assigned to receive Systane ® for their right eye and Eyestil ® for their left eye or to receive Tears Naturale II ® for their right eye and Refresh Tears ® for their left eyes . Outcomes were assessed at baseline and weeks 2 , 4 and 12 after treatment initiation . Results : Twenty-two patients received Systane ( right eye ) and Eyestil ( left eye ) and 21 patients received Tears Naturale ( right eye ) and Refresh ( left eye ) . At each visit and for each outcome , each treatment group demonstrated a significant improvement from baseline ( p < 0.001 ) ; however , none of these outcomes were significantly different among treatment groups at any visit . At week 12 , the mean OSDI improvement was similar between the Systane/Eyestil group ( −26.4 ± 10.6 ) and the Tears Naturale/Refresh group ( −27.6 ± 14.8 ) . The mean tear osmolarity decrease ( mOsm/L ) at week 12 was −33.8 ± 8.3 for Eyestil , −30.3 ± 9.2 for Refresh , −28.4 ± 8.2 for Systane and −25.7 ± 13.1 for Tears Naturale . The mean Schirmer ’s test increase at week 12 ( mm/5 min ) was 6.7 ± 3.4 for Eyestil , 6.4 ± 2.9 for Systane , 4.7 ± 2.4 for Tears Naturale and 4.7 ± 2.8 for Refresh . The mean TBUT increase at week 12 ( s ) was 7.0 ± 3.4 for Systane , 6.1 ± 3.3 for Eyestil , 5.8 ± 2.3 for Tears Naturale , and 5.6 ± 2.8 for Refresh . Conclusion : All four artificial tear formulations were effective in relieving dry eye signs and symptoms . Although the greatest improvement in two of the objective tests was achieved by Eyestil , the drug with the lowest osmolality , differences among the four artificial tear eye drops were not statistically significant BACKGROUND Most marketed artificial tears are substitutes for the aqueous layers of the tear film ; therefore , frequent instillation of artificial tears is necessary . Newer gel- , cellulose- , and mineral oil-based formulations have been design ed to overcome the disadvantages of current aqueous tear substitutes by offering prolonged retention times . OBJECTIVES The aim of this study was to compare the efficacy , safety , and local tolerance of artificial tears containing carbomer-based lipids or hydroxypropyl (HP)-guar gel in patients with dry eye syndrome . METHODS A 4-week , prospect i ve , r and omized , parallel-group , comparative , noninferiority study was conducted at the Taipei Medical University Hospital ( Taipei , Taiwan ) in patients with dry eye syndrome who were r and omly assigned to 1 of 2 treatment groups : the carbomer-based lipid-containing ( CBLC ) gel group and the HP-guar gel group . The primary end point was global assessment of study treatment by the patients at weeks 2 and 4 . All patients met the diagnostic criteria of impaired tear function and ocular surface abnormalities . Outcomes measured at baseline and 2 and 4 weeks included Schirmer 's test values , tear breakup time ( TBUT ) , and a patient subjective assessment of symptoms . Safety and tolerability were assessed by clinical ly significant changes in terms of incidence of adverse events and conducted by unmasked investigators . RESULTS A total of 30 Taiwanese patients with dry eye syndrome were included and r and omly assigned to the 2 treatment groups : the mean ( SD ) age was 40.37 ( 14.96 ) years in the CBLC gel group and 49.49 ( 12.20 ) years in the HP-guar gel group . At baseline , the mean ( SD ) Schirmer 's test value was 4.53 ( 2.28 ) mm in the right eye and 5.13 ( 2.42 ) mm in the left eye in the CBLC gel group ; 4.40 ( 2. 
    Output:
    
The review found that , in general , there was uncertainty whether different OTC artificial tears provide similar relief of signs and symptoms when compared with each other or placebo .
Our review also found that OTC artificial tears may be generally safe , but not without adverse events .
OTC artificial tears may be safe and effective means for treating dry eye syndrome ; the literature indicates that the majority of OTC artificial tears may have similar efficacies .