Effectiveness evaluation of hyaluronic acid-based commercial eye drops to treat ophthalmic dry eye disease

•HA + γ-PGA technology of Daydrop Advanced® is a novel treatment for ophthalmic DED.•New-generation Daydrop Advanced® provides the most effective and durable DED therapy.•DayDrop Advanced® eye drop is compared to Hyabak®, HyloComod® and Artelac Splash®.•DayDrop Advanced® boosts hydration, dehydration barrier and anti-hyaluronidase action.•DayDrop Advanced® enhances anti-inflammatory and ocular adhesion activities. Nowadays, hyaluronic acid (HA) eye drops are widely used to combat ophthalmic dry eye disease (DED). Till the date, almost all commercialized HA eye drops are single-ingredient despite not displaying significantly different clinical effects (Artelac Splash®). Consequently, scientists are making great efforts to combine HA with other compounds to overcome more successfully DED (trometamol in Hyabak®, sorbitol in HyloComod®). Gamma-polyglutamic acid (γ-PGA) is another novel polymer that could induce a powerful synergistic effect on HA for DED treatment. To the best of our knowledge, eye drops combining HA and γ-PGA neither have been marketed nor scientific studies have been published so far. Fortunately, DayDrop Advanced® eye drop has been recently commercialized with HA + γ-PGA technology. In this work, DayDrop Advanced®, Hyabak®, HyloComod® and Artelac Splash® were compared evaluating their efficacy to treat DED and residence time in eye due to their distinct physicochemical and rheological properties. As key research point, DayDrop Advanced® demonstrated an improved immediate hydration, protection against corneal dehydration, anti-inflammatory, anti-hyaluronidase and ocular mucoadhesion activities than the rest of artificial tears. These phenomena highlight new generation DayDrop Advanced® combining HA + γ-PGA technology as the leading eye drops to treat more durably and effectively DED. [Display omitted]