OBJECTIVE: To systematically review the efficacy and safety of loteprednol combined with sodium hyaluronate in the treatment of moderate-severe dry eye METHODS: Randomized controlled trials on loteprednol combined with sodium hyaluronate in the treatment of moderate-severe dry eye（ the research group was given loteprednol combined with sodium hyaluronate for eye-dropping

while the control group was given sodium hyaluronate alone） were retrieved from the Cochrane Library

PubMed

EMBase

CNKI

Wanfang database and CBM from basebuilding to Feb. 2021. After independently literature screening

information extracting and bias evaluation by two researchers

RevMan 5. 4 was adopted to conduct Meta-analysis. RESULTS: Totally 8 studies were involved

including771 patients（ 1 416 eyes）

of which 387 patients（ 710 eyes） were in the research group

and 384 patients（ 706 eyes）were in the control group. Results of Meta-analysis indicated that in terms of effectiveness

the total effective rate（ OR = 3. 14

95%CI= 1. 81-5. 45

P<0. 000 1）

score of dry eye symptom（ MD =-9. 49

95%CI =-9. 94--9. 04

P<0. 000 01）

breakup time of tear film（ BUT） at 2 weeks after treatment（ MD = 1. 92

95% CI = 1. 72-2. 12

P <0. 000 01）

BUT at 4 weeks after treatment（ MD = 3. 56

95% CI = 3. 22-3. 91

P < 0. 000 01）

BUT at 6 weeks after treatment（ MD = 4. 40

95%CI = 3. 97-4. 83

P<0. 000 01）

BUT at 8 weeks after treatment（ MD = 5. 14

95%CI = 4. 81-5. 48

P<0. 000 01）

score of corneal fluorescein staining at 2 weeks after treatment（ MD =-2. 27

95% CI =-2. 58--1. 97

P<0. 000 01）

score of corneal fluorescein staining at 6 weeks after treatment（ MD =-2. 42

95%CI =-2. 77--2. 06

P<0. 000 01）

score of corneal fluorescein staining at 8 weeks after treatment（ MD =-2. 67

95%CI =-2. 94--2. 40

P<0. 000 01） and result of Schirmer test（ Schirmer Ⅰ）（ MD = 0. 20

95% CI = 0. 11-0. 29

P < 0. 000 01） of research group were significantly higher those of the control group

with statistically significantly differences; in terms of safety

there was no statistical significance in the difference in incidences of adverse drug reactions between two groups（ OR = 0. 76

95% CI = 0. 37-1. 57

P = 0. 46 > 0. 05）. CONCLUSIONS: Present evidence shows that loteprednol combined with sodium hyaluronate is safe

effective and quickly effected in the treatment of moderate-severe dry eye

which has obvious advantages over sodium hyaluronate alone. The result evidence is limited by the quantity and quality of involved studies

and the above conclusions need to be verified by more high-quality studies.