What is the comparison between Cationorm (Cyclosporine) and Hylo Forte (Sodium hyaluronate) for treating dry eye syndrome?

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From the Guidelines

Both Cationorm and Hylo Forte are effective artificial tear products for dry eyes, but for most patients, Hylo Forte may be preferable due to its higher concentration of hyaluronic acid, which provides intensive moisture and helps heal the ocular surface 1.

Key Differences Between Cationorm and Hylo Forte

  • Cationorm is a cationic oil-in-water emulsion that contains mineral oils and works by attracting to the negatively charged ocular surface, providing longer-lasting lubrication and lipid replenishment.
  • Hylo Forte contains 0.2% sodium hyaluronate (hyaluronic acid), which provides intensive moisture and helps heal the ocular surface.

Recommendations for Use

  • For moderate to severe dry eye with inflammation, Cationorm may be preferable due to its lipid-replenishing properties.
  • For aqueous-deficient dry eye, Hylo Forte's higher concentration of hyaluronic acid might work better.
  • Both can be used 3-4 times daily.
  • Some patients benefit from using both: Hylo Forte during the day for moisture and Cationorm at night for overnight protection.

Important Considerations

  • If symptoms persist after 2-3 weeks of consistent use, consult an eye care professional as you may need prescription treatments for underlying inflammation 1.
  • Dry eye syndrome is a common ocular condition that has a substantial impact on the quality of life of afflicted individuals owing to discomfort and visual disability, and clinical examination is the gold standard for diagnosing dry eye syndrome 1.

From the Research

Comparison of Cationorm and Hylo Forte for Dry Eyes

  • Cationorm is a cationic nanoemulsion that contains cyclosporine A, which is used to treat keratoconjunctivitis sicca (KCS) by reducing inflammation and improving tear production 2.
  • Hylo Forte, on the other hand, contains sodium hyaluronate, which is a common ingredient in artificial tear preparations used to treat dry eyes.
  • Studies have shown that sodium hyaluronate can improve tear film osmolality, tear breakup time, and reduce rose bengal staining in patients with KCS 3, 4.
  • A study comparing sodium hyaluronate with polyvinyl alcohol found that neither preparation was superior to the other in treating KCS, but both improved tear film osmolality and rose bengal staining over an 8-week period 3.
  • Another study found that a tear substitute containing glycerol and hyaluronate (similar to Hylo Forte) was effective in reducing rose bengal staining and improving patient satisfaction in patients with KCS 5.
  • However, there is limited direct comparison between Cationorm and Hylo Forte in the provided studies, making it difficult to determine which one is more effective for treating dry eyes.
  • It is worth noting that cyclosporine A formulations, such as Cationorm, have been shown to have a faster onset of efficacy and improved bioavailability compared to traditional emulsion formulations 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The effect of a new tear substitute containing glycerol and hyaluronate on keratoconjunctivitis sicca.

Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics, 1998

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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