In vivo tear film parameters and ocular surface characteristics during the 5-week trial period of the eyes of rabbits instilled with undiluted MHME (1:10) or saline control. Data are presented as median (range) or mean±SD. Asterisks denote statistically significant differences (p<0.05).
| Preinstillation | Postinstillation | Preinstillation versus postinstillation p values | |||||||
| MHME | Saline control | p | MHME | Saline control | p | MHME | Saline control | ||
| Tear film lipid layer grade | Day 1 | 5 (4–5) | 5 (4–5) | 0.88 | 5 (4–5) | 5 (4–5) | 0.79 | 0.95 | 0.95 |
| Day 2 | 4.5 (4–5) | 5 (4–5) | 0.88 | 5 (5–5) | 5 (4–5) | 0.16 | 0.16 | >0.99 | |
| Day 3 | 5 (4–5) | 4.5 (4–5) | 0.88 | 5 (4–5) | 5 (4–5) | 0.79 | 0.95 | 0.95 | |
| Day 4 | 5 (4–5) | 5 (4–5) | 0.88 | 5 (5–5) | 5 (4–5) | 0.79 | 0.95 | 0.95 | |
| Day 5 | 5 (4–5) | 5 (4–5) | 0.88 | 5 (5–5) | 5 (4–5) | 0.16 | 0.95 | >0.99 | |
| p | 0.75 | 0.86 | 0.41 | 0.86 | |||||
| RM-ANOVA for treatment effect | 0.92 | 0.67 | 0.18 | 0.92 | |||||
| RM-ANOVA for time effect | 0.61 | 0.14 | 0.65 | 0.83 | |||||
| RM-ANOVA for interaction effect | 0.38 | 0.82 | 0.77 | 0.79 | |||||
| Tear film osmolarity (mOsmol/kg) | Day 1 | 341±25 | 361±236 | 0.87 | 318±14 | 357±23 | 0.09 | 0.13 | >0.99 |
| Day 2 | 353±16 | 356±28 | >0.99 | 338±32 | 345±27 | >0.99 | 0.80 | 0.83 | |
| Day 3 | 339±16 | 349±22 | >0.99 | 325±14 | 334±33 | >0.99 | 0.97 | 0.67 | |
| Day 4 | 342±31 | 347±16 | >0.99 | 328±32 | 330±11 | >0.99 | 0.92 | 0.53 | |
| Day 5 | 343±17 | 351±29 | >0.99 | 332±34 | 336±22 | >0.99 | >0.99 | 0.66 | |
| p | 0.41 | 0.81 | 0.45 | 0.16 | |||||
| RM-ANOVA for treatment effect | 0.76 | 0.10 | 0.38 | 0.22 | |||||
| RM-ANOVA for time effect | 0.18 | 0.47 | 0.12 | 0.18 | |||||
| RM-ANOVA for interaction effect | 0.93 | 0.13 | 0.94 | 0.96 | |||||
| Tear evaporation rate (g/m2/hour) | Day 1 | 22±13 | 24±8 | 0.46 | 24±5 | 29±9 | 0.59 | 0.80 | 0.60 |
| Day 5 | 15±7 | 14±5 | 0.11 | 19±8 | 20±6 | 0.08 | 0.46 | 0.82 | |
| p | 0.58 | 0.61 | 0.48 | 0.08 | |||||
| RM-ANOVA for treatment effect | 0.98 | 0.08 | 0.13 | 0.16 | |||||
| RM-ANOVA for time effect | 0.10 | 0.35 | 0.10 | 0.33 | |||||
| RM-ANOVA for interaction effect | 0.44 | 0.31 | 0.68 | 0.81 | |||||
| Phenol red thread (mm) | Day 1 | 23±3 | 21±4 | 0.82 | 23±5 | 23±4 | >0.99 | 0.99 | 0.43 |
| Day 5 | 20±7 | 21±4 | 0.87 | 23±3 | 23±4 | >0.99 | 0.31 | 0.66 | |
| p | 0.53 | >0.99 | 0.85 | 0.86 | |||||
| RM-ANOVA for treatment effect | 0.66 | 0.95 | 0.79 | 0.20 | |||||
| RM-ANOVA for time effect | 0.91 | 0.89 | 0.38 | >0.99 | |||||
| RM-ANOVA for interaction effect | 0.48 | 0.59 | 0.33 | 0.77 | |||||
| Conjunctival hyperaemia grade | Day 1 | 0.75 (0–1.5) | 0.75 (0–1) | 0.16 | 0.75 (0–1) | 0.75 (0–1) | >0.99 | 0.52 | >0.99 |
| Day 2 | 0.5 (0–0.5) | 0.50 (0–0.75) | >0.99 | 0.25 (0–0.5) | 0.25 (0.25–1) | 0.23 | 0.95 | >0.99 | |
| Day 3 | 0.25 (0–0.5) | 0.25 (0–0.5) | >0.99 | 0.25 (0–0.5) | 0.25 (0–0.75) | >0.09 | 0.95 | >0.99 | |
| Day 4 | 0.25 (0.25–0.5) | 0.25 (0–0.5) | >0.99 | 0.25 (0–0.5) | 0.5 (0–1) | 0.07 | >0.99 | 0.40 | |
| Day 5 | 0.25 (0–0.5) | 0.50 (0–0.5) | >0.99 | 0.25 (0–0.5) | 0.25 (0–0.5) | >0.99 | >0.99 | 0.92 | |
| p | 0.19 | 0.15 | 0.68 | 0.21 | |||||
| RM-ANOVA for treatment effect | 0.14 | 0.08 | 0.47 | 0.34 | |||||
| RM-ANOVA for time effect | 0.80 | 0.17 | 0.93 | 0.64 | |||||
| RM-ANOVA for interaction effect | 0.12 | 0.43 | 0.85 | 0.43 | |||||
| Corneal opacity grade | Day 1 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 |
| Day 2 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| Day 3 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| Day 4 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| Day 5 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| p | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| RM-ANOVA for treatment effect | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| RM-ANOVA for time effect | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| RM-ANOVA for interaction effect | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| Iris appearance grade | Day 1 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 |
| Day 2 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| Day 3 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| Day 4 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| Day 5 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| p | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| RM-ANOVA for treatment effect | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| RM-ANOVA for time effect | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| RM-ANOVA for interaction effect | >0.99 | >0.99 | >0.99 | >0.99 | |||||
| Conjunctival sodium fluorescein staining score | Day 1 | 0.25 (0–0.5) | 0 (0–0) | 0.35 | 0 (0–0.5) | 0.25 (0–1) | 0.93 | 0.99 | 0.43 |
| Day 2 | 0 (0–1) | 0 (0–1.5) | 0.35 | 0 (0–1) | 0.5 (0–1.5) | 0.20 | 0.85 | 0.80 | |
| Day 3 | 0 (0–0.25) | 0 (0–0.5) | >0.99 | 0 (0–0.5) | 0 (0–0.25) | >0.99 | 0.95 | >0.99 | |
| Day 4 | 0 (0–0) | 0.25 (0–0.5) | 0.35 | 0 (0–0.25) | 0 (0–0.25) | >0.99 | 0.99 | 0.99 | |
| Day 5 | 0 (0–0) | 0 (0–0.25) | >0.99 | 0 (0–0) | 0 (0–1) | >0.99 | >0.99 | 0.99 | |
| p | >0.99 | >0.99 | 0.68 | 0.21 | |||||
| RM-ANOVA for treatment effect | 0.39 | 0.21 | 0.78 | 0.53 | |||||
| RM-ANOVA for time effect | 0.13 | 0.12 | 0.42 | 0.37 | |||||
| RM-ANOVA for interaction effect | 0.07 | 0.47 | 0.82 | 0.21 | |||||
| Corneal sodium fluorescein staining score | Day 1 | 0 (0–0) | 0 (0–0.5) | 0.33 | 0 (0–0) | 0 (0–0.5) | 0.82 | >0.99 | >0.99 |
| Day 2 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | >0.99 | |
| Day 3 | 0 (0–0) | 0 (0–0) | >0.99 | 0 (0–0) | 0 (0–0.25) | 0.82 | >0.99 | 0.14 | |
| Day 4 | 0 (0–0) | 0 (0–0.25) | >0.99 | 0 (0–0) | 0 (0–0.25) | 0.82 | 0.17 | 0.14 | |
| Day 5 | 0 (0–0) | 0 (0–0.25) | >0.99 | 0 (0–0) | 0 (0–0) | >0.99 | >0.99 | 0.77 | |
| p | >0.99 | 0.65 | 0.41 | 0.15 | |||||
| RM-ANOVA for treatment effect | 0.68 | 0.18 | 0.43 | 0.59 | |||||
| RM-ANOVA for time effect | 0.12 | 0.11 | 0.36 | 0.30 | |||||
| RM-ANOVA for interaction effect | 0.68 | 0.65 | 0.43 | 0.75 | |||||
MHME, Manuka honey microemulsion; RM-ANOVA, repeated measures analysis of variance; SD, standard deviation.