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OBJECTIVE: To probe into the efficacy of rituximab in the treatment of recurrent primary Sjögren syndrome (pSS) associated dry eye, so as to provide reference for clinical treatment. METHODS: Totally 81 patients with recurrent pSS associated xerophthalmia admitted into this hospital from Jan. 2015 to Aug. 2021 were selected and divided into two groups by random number table. The control group (41 cases, 82 eyes) was given prednisone acetate, hydroxychloroquine sulfate and cyclophosphamide for systemic administration and topical eye drops for 8 weeks; while the observation group (40 cases, 80 eyes) were given rituximab 375 mg/m² for intravenous drip based on the control group, once a week for 8 weeks. Scores of the standard patient evaluation of eye dryness (SPEED) questionnaire, rupture time of tear film, scores of Schirmer Ⅰ tear secretion test and corneal fluorescein staining of the two groups were observed, incidence of adverse drug reactions and recurrence during follow-up were recorded. RESULTS: After treatment, the SPEED scores of eye dryness, foreign body sensation, pain, burning sensation or tearing and total score, and scores of corneal fluorescein staining of both groups were significantly lower than before treatment, the rupture time of tear film was longer than before treatment, and the length of Schirmer I tear secretionsoaked filter paper was increased compared with before treatment in both groups, with statistically significant differences (P<0. 01). The SPEED scores of eye dryness [(2. 15±0. 36) points vs. (3. 26±0. 47) points], foreign body sensation [(2. 11±0. 28) points vs. (3. 02±0. 40) points], pain [(2. 03±0. 28) points vs. (2. 95±0. 36) points], burning sensation or tearing [(1. 26±0. 24 ) points vs. (2. 15±0. 39) points] and total score [(7. 55± 1. 46) points vs. (11. 38±2. 74) points], and scores of corneal fluorescein staining [(3. 11±0. 53) points vs. (4. 02± 0. 69) points] of the observation group were lower than those of the control group after treatment, and the rupture time of tear film [(9. 57±2. 03) s vs. (7. 35±1. 95 ) s] of the observation group was longer than that of the control group, the length of Schirmer Ⅰ tear secretion-soaked filter paper [(8. 97 ±2. 17) mm vs. (6. 95 ±1. 72) mm] of the observation group was greater than that of the control group, with statistically significant differences (P<0. 01). The recurrence rate of the observation group [5. 00% (2/40) vs. 24. 39% (10/41)] was lower than that of the control group, with statistically significant difference (P<0. 05). The difference in the incidences of adverse drug reactions between two groups was not statistically significant ( P > 0. 05). CONCLUSIONS: Compared with conventional treatment, the application of rituximab for recurrent pSS associated dry eye can significantly induced lacrimal secretion, improved dry eye symptoms and reduced the risk of recurrence. [ABSTRACT FROM AUTHOR]