Background: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability and inflammation. Rebamipide 2% ophthalmic suspension, a mucin secretagogue, has been investigated as a potential treatment due to its unique mechanism targeting mucin deficiency and ocular surface repair. Methods: A systematic search of PubMed, Embase, and Cochrane Library was conducted for studies published between January 2013 and March 2025. Non-randomized and randomized controlled trials evaluating topical 2% rebamipide in patients with DED were included. Outcomes assessed included tear breakup time, Schirmer I test, fluorescein staining scores, ocular surface disease index, and adverse events. Data were synthesized using standard meta-analytic techniques and subgroup analyses. Results: Thirteen studies, including both randomized and non-randomized trials, were analyzed, comprising a total of 575 participants. Meta-analysis showed that rebamipide nonsignificantly increased tear breakup time at 2 weeks (standardized mean difference [SMD] = 1.04; 95% confidence interval (CI):–0.94 to 3.03; P = .30; I ² = 89.3%), significant at 4 weeks (SMD = 1.19; 95% CI: 0.74–1.64; P < .0001; I ² = 85%) and nonsignificant at 12 weeks (SMD = 0.97; 95% CI:–0.15 to 2.08; P = .09; I ² = 80.1%) indicating enhanced tear film stability. Schirmer I test values showed no significant improvement (SMD = 0.04; 95% CI: −0.35–0.43; P = .83), suggesting limited effect on aqueous tear production. Fluorescein staining scores showed a reduction approaching statistical significance (SMD = −0.68; P = .051), while symptom scores measured by ocular surface disease index trended toward improvement, also approaching significance (SMD = −1.17; P = .055). Subgroup analyses revealed greater efficacy in contact lens wearers and postsurgical patients. Safety analysis indicated excellent tolerability, with a high adherence rate (96.8%) and only mild adverse effects such as dysgeusia and nasopharyngitis. Conclusion: Rebamipide 2% ophthalmic suspension improves tear stability and ocular surface health in mucin-deficient DED with a favorable safety profile. Further high-quality trials in diverse populations are warranted to confirm its role in global clinical practice.

Takotsubo syndrome (TTS), also known as broken heart syndrome, is an acute cardiac condition with a poorly understood pathophysiology due to its relative rarity. Once considered benign, it is now recognized as a serious disorder with severe complications and a mortality rate comparable to or exceeding that of acute coronary syndrome. This narrative review aims to summarize current knowledge on the prognostic factors associated with TTS, with a particular focus on its relationship with diabetes mellitus (DM). A thorough analysis of 57 relevant studies, selected from over 98,000 articles retrieved from PubMed and Google Scholar, was conducted based on strict inclusion criteria. The findings indicate that advanced age, female sex, pre-existing cardiovascular diseases, and systemic disorders significantly influence the prognosis and mortality of patients with the syndrome. DM plays a paradoxical role, being associated with increased long-term mortality risk while potentially providing a protective effect during the acute phase of the syndrome, possibly by modulating stress responses involved in its onset. Therefore, a deeper understanding of the prognostic implications of TTS and its interaction with diabetes is crucial for developing appropriate risk stratification tools and improving clinical management of patients.