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This review aims to critically evaluate the literature on the safety and efficacy of artificial tears containing HA used in DED treatment. Literature searches were conducted in PubMed, including MEDLINE, and in Embase\n                    <jats:italic>via<\/jats:italic>\n                    Ovid with the search term: \u201c(hyaluronic acid OR hyaluronan OR hyaluronate) AND (dry eye OR sicca)\u201d. A total of 53 clinical trials are included in this review, including eight placebo\u2010controlled trials. Hyaluronic acid concentrations ranged from 0.1% to 0.4%. Studies lasted up to 3\u2009months. A broad spectrum of DED types and severities was represented in the reviewed literature. No major complications or adverse events were reported. Artificial tears containing 0.1% to 0.4% HA were effective at improving both signs and symptoms of DED. Two major gaps in the literature have been identified: 1. no study investigated the ideal drop frequency for HA\u2010containing eyedrops, and 2. insufficient evidence was presented to recommend any specific HA formulation over another. Future investigations assessing the optimal drop frequency for different concentrations and molecular weights of HA, different drop formulations, including tonicity, and accounting for DED severity and aetiology are essential for an evidence\u2010based, individualized approach to DED treatment.\n                  <\/jats:p>","DOI":"10.1111\/aos.15159","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T01:15:33Z","timestamp":1651799733000},"page":"844-860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":156,"title":["Hyaluronic acid in the treatment of dry eye disease"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7762-831X","authenticated-orcid":false,"given":"Leif","family":"Hynnekleiv","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Oslo University Hospital Oslo Norway"},{"name":"Department of Ophthalmology 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