Medicine · 8 authors, 2 centres
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The combined intervention significantly improved tear breakup time (SMD = 1.25, 95% CI 1.14 to 1.37, P < .0001), Schirmer I test scores (SMD = 1.55, 95% CI 1.08 to 2.02, P < .0001), and corneal fluorescein staining (SMD = -2.08, 95% CI -2.96 to -1.20, P < .00001).
The combined intervention significantly improved tear breakup time (SMD = 1.25, 95% CI 1.14 to 1.37, P < .0001), Schirmer I test scores (SMD = 1.55, 95% CI 1.08 to 2.02, P < .0001), and corneal fluorescein staining (SMD = -2.08, 95% CI -2.96 to -1.20, P < .00001). Inflammatory markers IL-6 and TNF-α were also significantly reduced, and the overall efficacy rate favored the combined group (OR = 4.09, 95% CI 3.04 to 5.51, P < .00001). No significant difference was found for OSDI (P = .15). Adverse events were limited to dropout and rare hematoma or fainting, with no serious adverse events reported. The authors noted all included studies had small sample sizes, variable quality, short follow-up, and heterogeneous designs.
