The Best Dry Eye Drops. The Best Preservative-Free Eye Drops

Many patients have used these product and love it. They are both preservative-free. They both have their positive and negatives.

Hycosan has the same material eye surgeons place in the eye ball and on the cornea to protect delicate eye cells: Sodium hyaluronate.  I have not see a head-to-head study saying this is the best preservative-free eye drop, but I have some severe dry eye patients who love this drop.

Hycosan Extra is a sterile, phosphate and preservative-free solution containing 2 mg/ml sodium hyaluronate, a citrate buffer, sorbitol and water.

Retaine has been studied independently among other non-preserved tears but not against Hycosan.

Details About Retaine:
  • Cationic Ophthalmic Emulsion — This drop has a positive molecular charge so it will stick better to the corneal surface, which has an overall negative ionic charge. 
  • Lipid-Stabilizing Molecular Make Up — I still have not seen any study that Retaine saves the meibomian glands (MG) or truly treats Meibomian Gland Dysfunction (MGD). Still this drop is meant to support and reinforce the natural fatty or lipid layer produced by the meibomian glands. This tries to keep your own tear film on your eye longer.
  • Preservative Free — Preservatives-free drops are best for the health of the cornea. Preservatives kill bacteria and pathogens, but they are toxic to the delicates cells of the eye.  Likely part of the increased risk of dry eye with contact lens users is due to the the years of preservatives used in contact lens solutions touching the cornea. Preservatives are also the main source of burning and stinging for most people when they use over the counter eye drops.  Drops with preservatives may say not to use them more than 4x per day, but more and more studies are showing the more you use drops with preservatives, the more your eye’s surface cells are likely to be affected. (No study has showed preservative-containing drops destroy meibomian glands yet.) Preservative free drops can be used as often as needed. Still I do have some patients that do not like Retaine. 
  • Longer-Lasting but Not Blurring: This is a thick drop but usually does not cause persistent blurry vision as many thick drops and gels and ointments do. The ionic charge of the molecular makeup causes Retaine MGD to spread evenly over the ocular surface as you blink, and then stay evenly spread in between your blinks.  The effect is a noticeable feeling of comfort, without the blurry vision induced by similar thicker drops like gel artificial tears currently on the market.

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