Twenty-two patients with rheumatoid arthritis and moderate to severe bilateral keratoconjunctivitis sicca were treated with artificial tears and a soluble slow-release artificial tear insert in a crossover trial. While using the inserts all but two patients reported an improvement in their symptoms. All the patients showed an improvement in the degree of conjunctival and corneal staining while using the inserts (p = 0.0001 and 0.00001 respectively). Nineteen patients (86%) found the inserts an acceptable form of therapy and 14 (64%) preferred them to other treatment regimens. Placement of the insert was not a problem despite all the patients having rheumatoid changes in their hands resulting in varying degrees of deformity. Two patients experienced initial difficulties with placement, but these were quickly resolved.
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