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Tear film lipid layer is secreted from meibomian glands and stabilizes the tear film. We recently showed that diquafosol administration increased lipid layer thickness (LLT) for up to 60\u2009min in normal human eyes. We here evaluated tear film lipid layer in DE patients (<jats:italic>n<\/jats:italic>\u2009=\u200947) with meibomian gland dysfunction (MGD) before as well as 30, 60, and 90\u2009min after diquafosol administration. One drop of artificial tears or one drop of diquafosol was applied randomly to the eyes of each patient. Diquafosol significantly increased LLT at 30 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and 60 (<jats:italic>P<\/jats:italic>\u2009=\u20090.042) min and noninvasive tear film breakup time for at least 90\u2009min (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 at each assessment point). Artificial tears had no such effect. Diquafosol significantly improved the tear interferometric pattern compared with artificial tears (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 at each assessment point). A single topical administration of diquafosol thus improved LLT and tear film stability in DE patients with MGD, suggesting that diquafosol is a potential treatment not only for aqueous-deficient DE but also for evaporative DE associated with MGD.<\/jats:p>","DOI":"10.1038\/s41598-019-45475-7","type":"journal-article","created":{"date-parts":[[2019,6,24]],"date-time":"2019-06-24T10:03:11Z","timestamp":1561370591000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Tear film lipid layer increase after diquafosol instillation in dry eye patients with meibomian gland dysfunction: a randomized clinical study"],"prefix":"10.1038","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-6061","authenticated-orcid":false,"given":"Shima","family":"Fukuoka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Arita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,6,24]]},"reference":[{"key":"45475_CR1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jtos.2016.09.003","volume":"15","author":"K Tsubota","year":"2017","unstructured":"Tsubota, K. et al. 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