gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

To develop a new lubricant and nutrient tear substitute

Meeting Abstract

  • corresponding author L. Liu - Department of Ophthalmology, University of Lübeck, Lübeck
  • J. M. Tiffany - Nuffield Laboratory of Ophthalmology, University of Oxford, UK
  • C. P. Siegers - Institute of Pharmacology, University of Lübeck, Lübeck
  • G. Geerling - Department of Ophthalmology, University of Lübeck, Lübeck

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.12.04

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Liu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Tear substitutes, the most widely used therapy for dry eye, usually only provide lubrication for the ocular surface. We aimed to produce a new tear substitute capable of providing lubrication and nutrition in one, based on a defined keratinocyte serum free cell culture medium and supplemented with various lubricants also included in commercially available tear substitutes.


Hydroxypropylmethylcellulose (HPMC), carbopol 980, and Sodium Hyaluronate (SH) were dissolved in the medium to the concentrations of 0.4%, 0.2%, 0.1%, 0.05%, 0.025% and 0.0125%. PH, osmolarity, viscosity and surface tension were measured for all the formulations. Two human corneal epithelial cell lines (HCE-T and CEPI-17-CL4) and two conjunctival epithelial cell lines (Chang and IOBA-NHC) as well as primary rabbit corneal epithelial cells were used to investigate cell proliferation, viability and migration in response to the formulations by means of a luminescence based ATP-assay, a LIVE/DEAD viability/cytotoxicity assay and a colony dispersion assay.


The pH of the medium was 7.2, osmolarity was 278 mOsm/L, surface tension was 73 mN/m and viscosity was 25 mPa.sec. The surface tension of medium was reduced by adding HPMC, but not by carbopol 980 and SH. All additives increased the viscosity of the medium significantly at all the concentrations. An HPMC containing formulation supported cell proliferation and viability better than carbopol 980 and SH, especially at concentrations higher than 0.1% and with exposure time longer than 96 h. None of the formulations supported cell migration.


DKSFM with HPMC shows superior lubricant and nutrient properties and could be an ideal tear substitute for dry eye. The optimal concentration is 0.2%, since HPMC-adjusted culture medium at this concentration could provide moderate viscosity, has a surface tension similar to natural tears and supports cell proliferation best. Its effect on severe ocular surface disease should be evaluated in a randomised controlled clinical trial.