The data are presented as mean ± standard deviation (SD). The statistical package for the social sciences (SPSS) software version 21.0 (SPSS, Chicago, IL, USA) was used for the statistical analyses. The differences in the tear volume, tear film BUT, and fluorescein staining scores between the groups were evaluated by using a oneway analysis of variance (ANOVA) test with Tukey’s post hoc analysis. The Kruskal-Wallis and Mann-Whitney test were used to compare the cytokine and chemokine levels, goblet and 4-HNE-positive cell densities, and flow cytometry differences between the groups. A value < 0.05 was considered statistically significant