Compounded 0.03% Tacrolimus in Cross-Linked Hyaluronate Improves Ocular Surface Health in Dogs With Evaporative Dry Eye Disease.

Compounded 0.03% tacrolimus in cross-linked hyaluronate significantly improves tear stability and ocular surface health in dogs with evaporative dry eye.

This prospective, open-label clinical trial evaluated the efficacy of a compounded formulation combining 0.03% tacrolimus in 0.75% cross-linked hyaluronic acid (XHA) for managing evaporative dry eye disease (EDED) in dogs. Sixteen client-owned dogs with confirmed EDED—characterized by normal aqueous tear production but reduced tear film stability—were treated twice daily for 45 days. Comprehensive ophthalmic assessments were performed at baseline, Day 15, and Day 45. Schirmer tear test-1 (STT-1) values increased significantly from 18.7 to 21.7 mm/min by Day 45 (p = 0.004), suggesting a modest but meaningful improvement in aqueous production. Tear film breakup time (TFBUT) demonstrated marked improvement, rising from 3.3 seconds at baseline to 8.1 seconds at Day 45 (p < 0.001), indicating substantially enhanced tear film stability. Corneoconjunctival integrity improved significantly, with punctate fluorescein staining scores decreasing from 1.8 to 0.3 (p < 0.001) and lissamine green staining scores dropping from 1.9 to 0.1 (p < 0.001). Conjunctival hyperemia also declined significantly by Day 45 (p = 0.041). No adverse events were reported. The combination of tacrolimus-mediated immunomodulation with the prolonged lubrication provided by cross-linked hyaluronic acid offers a clinically practical, single-formulation approach to treating canine qualitative dry eye. This study supports XHA/tacrolimus as a promising therapeutic option for EDED management in small animal ophthalmology.

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