Purpose: To compare the clinical efficacy of four different liposomal sprays for dry eye treatment. Methods: Prospective randomized consecutive intraindividual comparison enrolling 166 patients (age, 18 - 93 years). Patients were randomly assigned to one of 4 groups, receiving one spray in their right eye and another one in their left eye: Ocuvers Hyaluron (OH) (87 eyes) and Ocuvers Lipostamin (OL) (80 eyes) (Innomedis AG), and Tears Again (TA) (80 eyes) and Tears Again Sensitive (TAS) (85 eyes) (Optima Pharmaceutical). Symptomatology was evaluated with the OSDI (Ocular Surface Disease Index) questionnaire. Subjective comfort, tear break up time (TBUT), redness, tear meniscus, application comfort and smell were evaluated during a 30-minute follow-up. Results: Smell for TA and TAS was significantly fattier compared to OH and OL (p Conclusions: The four evaluated liposome sprays may be useful for dry eye treatment, with higher subjective comfort and less dry eye signs using the Ocuvers sprays. The use of OL may be a better treatment option for severe dry eye.