TITLE:
Clinical Implications of Seawater in Reducing MMP-9 Levels in Eye Disorders: A Clinical Trial in Allergic Conjunctivitis
AUTHORS:
Manuel Diaz-Llopis, Maria Dolores Pinazo-Duran, Loreto Diaz-Guiñon, Miriam Rahhal-Ortuño, Roberto Gallego-Pinazo, Rosa Dolz-Marco, Teresa Diaz-Guiñon, Maria Diaz, Francisco Javier Romero, Ana Brotons-Canto
KEYWORDS:
Allergic Conjunctivitis, InflammaDry® Test, Seawater, Isotonic Ophthalmic Solution, MMP-9 Tear Level, Ocular Surface Inflammation, Deep Seawater
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.15 No.4,
September
19,
2025
ABSTRACT: Background: Allergic conjunctivitis is one of the most common allergic manifestations, affecting 20% of the global population. Elevated tear levels of matrix metalloproteinase 9 (MMP-9) have been correlated with the severity and chronicity of clinical manifestations of the disease. All current treatments, especially the most effective ones, are associated with side effects upon chronic administration. A natural treatment alternative without side effects that reduces pharmacodependence would be an excellent therapeutic option. This study aims to evaluate the anti-inflammatory efficacy of isotonic seawater solution on MMP-9 levels in the tears of patients with allergic conjunctivitis. Methods: This is a prospective study in which a total of 50 patients and 100 affected eyes were followed over time. Initial inclusion criteria were positive InflammaDry® test in both eyes + grade I, II, and III allergic conjunctivitis - Bonini-Gokhale scale. All patients were treated exclusively with Quinton® Eye Health, an isotonic seawater solution, six times a day for four weeks. Results: The InflammaDry test was positive in 100% of patients and eyes before treatment as an inclusion criterion. After seawater treatment, 100% of patients and eyes with grade I conjunctivitis tested negative with undetectable MMP-9 levels in both eyes, 89% with grade II conjunctivitis, and 80% of patients with grade III. These changes are statistically significant. Conclusion: Seawater washes are a safe and highly effective treatment in reducing ocular surface inflammation in allergic conjunctivitis, being able to negate previously positive MMP-9 tear levels in an average of 89% of cases.