The efficacy of acupuncture in the management of Dry Eye Syndrome: an integrative review
Description
Introduction: Dry Eye Syndrome (DES) is a multifactorial disease commonly managed with palliative therapies that do not target its underlying pathophysiological mechanisms. Acupuncture has emerged as a complementary therapy with potential neuroimmune and anti-inflammatory effects. Objective: To evaluate the efficacy of acupuncture in the management of DES compared with placebo or conventional treatments. Methods: This is an integrative review conducted using PubMed, Cochrane Library, Scopus, and Web of Science databases through May 2026. Randomized controlled trials, systematic reviews, and meta-analyses evaluating acupuncture in adults with DES were included. Of the 1,128 records identified, 12 studies met the eligibility criteria. Methodological quality was assessed using the QSAT, JADAD, and AMSTAR 2 tools. Results: Acupuncture consistently improved objective outcomes, including tear break-up time (TBUT), Schirmer test scores, and corneal fluorescein staining (CFS), compared with artificial tears. Electroacupuncture and acupuncture combined with conventional therapy further enhanced tear production and treatment response. In contrast, evidence for subjective outcomes, including the Ocular Surface Disease Index (OSDI) and Visual Analog Scale (VAS), remained inconsistent across studies. Reported adverse events were mild, supporting the favorable safety profile of acupuncture. Conclusion: Acupuncture appears to be a safe and clinically relevant complementary therapy for DES, particularly for improving tear production, tear film stability, and ocular surface integrity. However, the certainty of the evidence is limited by methodological heterogeneity and risk of bias. Further high-quality randomized controlled trials with standardized protocols are needed to confirm its long-term efficacy. Keywords: Acupuncture; Electroacupuncture; Dry Eye Syndrome; Ocular Surface Disease; Therapeutics.