The clinical investigation was intended to investigate the efficacy, ocular tolerability and safety of Vizol S Lipid Balance, a new eye drops, emulsion developed by JADRAN - GALENSKI LABORATORIJ d.d., in patients with moderate to severe evaporative DED after a treatment for 30 days.

Inclusion Criteria:

• use of eyelid hygiene for at least 14 days prior to screening
• diagnosis of moderate to severe dry eye disease (DED), with an Ocular Surface Disease Index (OSDI) score ≥23
• Tear Film Break-Up Time (TFBUT) <10 seconds in one or both eyes
• Meibomian gland expression of grade 2 or higher in both eyes
• written informed consent, after having been informed about benefits and potential risks of the clinical trial, as well as details of the insurance taken out to cover the patients participating in the clinical trial

Exclusion Criteria:

• intolerance or hypersensitivity to any component of the Investigational Product (IPs)
• ocular or intraocular surgery or serious ocular trauma ≤6 months before enrolment
• current punctal occlusion of any type
• use of concomitant topical ocular medications within 24 hours prior to first intended administration of the IPs (except for artificial tears or lubricants; previously used artificial tears or lubricants must be suspended for the duration of the study)
• use of systemic medications that may contribute to dry eye (unless on a stable regimen for ≥30 days before screening and throughout the study)
• current or previous topical treatment of the eye with antibiotics, steroids or cyclosporin A within the last four weeks
• ocular or systemic infections or conditions (e.g., epithelial herpes simplex keratitis, vaccinia, varicella, or mycobacterial infection, fungal disease, iritis) or other relevant ocular pathology judged by the investigator that preclude safe administration of the IPs
• use of contact lenses within 1 week before screening and throughout the study
• active ocular disease other than DED or any other acute or chronic disease which may interfere with the aims of the clinical trial
• history of severe allergies or multiple drug allergies unless it is judged as not relevant for the clinical trial by the investigator
• diagnosis of Corona Virus Disease (COVID-19) within the last 14 days prior to individual enrolment of the patient
• contact to persons in international risk areas for COVID-19 as defined by the Institute of Public Health of Serbia within the last 14 days prior to individual enrolment of the patient
• known direct contact with insufficient protection to persons with diagnosis of COVID-19 within the last 14 days prior to individual enrolment upon reporting of the patient
• history of or current drug or alcohol dependence
• participation in an investigational drug or device study ≤30 days before screening
• positive pregnancy test at screening examination
• pregnant or lactating women
• female patients who do not agree to apply highly effective contraceptive methods (highly effective contraceptive methods are defined in chapter 13.2.1)
• patients suspected or known not to follow instructions
• patients who are unable to understand the written and verbal instructions, in particular regarding the risks and inconveniences they will be exposed to during their participation in the clinical trial

Individual Participant Datas (IPDs) are available to the Health Authorities on a request

As the clinical trial will be conducted in a double-blind way, both investigators and patients will be blind with respect to the treatment administered. For the purpose of individual unblinding of a patient's treatment the investigator will receive a sealed emergency envelope for each patient containing the treatment code (Only in case of medical emergency it is permitted to open the emergency envelope).