Comparative Analysis of Honey-Based and Hyaluronic Acid Eye Drops on Tear Film Stability in Post-Menopausal Dry Eye Disease
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Background: Postmenopausal women are vulnerable to dry eye disease because hormonal changes may alter lacrimal function, meibomian gland activity, ocular surface homeostasis, and tear-film stability. Honey-based and hyaluronic acid-based eye drops may improve dry eye parameters through different biological mechanisms, but direct comparative evidence in postmenopausal women remains limited. Objective: To compare the effects of honey-based and hyaluronic acid-based eye drops on tear-film stability and tear secretion among postmenopausal women with dry eye disease. Methods: This quasi-experimental pre–post comparative study included 100 postmenopausal women with clinically diagnosed dry eye disease. Participants were divided into two equal groups: 50 received honey-based eye drops and 50 received hyaluronic acid-based eye drops, administered once daily for four weeks. Tear break-up time and Schirmer test wet length were measured at baseline and after treatment. Normality was assessed using the Shapiro–Wilk test. Within-group and between-group comparisons were performed using Wilcoxon signed-rank and Mann–Whitney U tests, respectively. Results: Both groups showed significant improvement in tear break-up time and Schirmer test values after four weeks. TBUT increased from 5.86 ± 1.49 to 9.60 ± 1.50 seconds in the hyaluronic acid group and from 5.78 ± 1.63 to 9.02 ± 1.56 seconds in the honey-based group. Schirmer test values increased from 7.22 ± 1.51 to 11.40 ± 1.73 mm and from 6.72 ± 1.23 to 10.16 ± 1.70 mm, respectively. Post-treatment outcomes favored hyaluronic acid for TBUT and Schirmer test. Conclusion: Both eye drop formulations improved objective dry eye parameters, but hyaluronic acid-based eye drops showed greater post-treatment improvement in tear-film stability and tear secretion.
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