Add on topical 0.05% cyclosporine A to post-refractive surgery treatment can reduce inflammation dry eye disease symptoms: Study

FS-LASIK is one of the most common refractive surgeries aimed at correcting vision; however, instability on the ocular surface in the postoperative stage may reduce recovery and raise discomfort to patients. Topical antibiotics, corticosteroids, and artificial tears are conventionally applied medications for such patients. The current study evaluated whether the addition of 0.05% CsA eye drops would promote ocular healing and reduce inflammation after FS-LASIK.

Sixty-six patients (eyes) undergoing FS-LASIK were randomized into two groups. Group I (33 eyes) received conventional treatment: topical levofloxacin, fluorometholone, and artificial tears. Group II (33 eyes) received the same conventional treatment plus 0.05% CsA eye drops twice daily for three months. The key outcome measures were the Ocular Surface Disease Index, numerical rating scale, tear break-up time, Schirmer I test, corneal fluorescein staining, conjunctival lissamine green staining, corneal sensitivity, and corneal nerve morphology. The inflammatory levels of cytokines in tears were measured with the Luminex assay. Patients had to be assessed preoperatively and at 1 and 3 months postoperatively.

The key findings of the study were:

• The study revealed significant improvements in the CsA group compared to the conventional treatment group.

• OSDI Scores: Improved more significantly in the CsA group.

• TBUT: Longer tear break-up time in the CsA group.

• LG Staining: Lower lissamine green staining scores of the lower conjunctiva in the CsA group.

• Corneal Sensitivity: The CsA group recovered better.

• Corneal Nerve Fiber Total Branch Density: This was higher in the CsA group.

• Regarding inflammatory cytokines, INF-γ, IL-10, and IL-6 levels were much more abated in the CsA group than the other measured cytokines, indicating a stronger anti-inflammatory response.

• No significant differences were noted between the two arms with regard to NRS, SIt, and CFS scores.

Addition of 0.05% CsA eye drops to conventional medication in the post-FS-LASIK patient course obviously provided advantages for ocular surface stability maintenance. The measures of ocular health were more recovered, and the levels of inflammatory cytokines were lower in the CsA group. This strongly indicates that CsA eye drops enhance healing processes and are more potent in anti-inflammatory effects compared with the conventional medication alone.

Reference:

Zhao, L., Duan, H., Ma, B., Yang, T., Zhou, Y., Liu, Y., Chen, J., Chen, Y., & Qi, H. (2024). Impact of topical 0.05% cyclosporine A eye drops on post–femtosecond-assisted laser in situ keratomileusis ocular surface recovery: A randomized clinical trial. Eye & Contact Lens, 10.1097/ICL.0000000000001103. https://doi.org/10.1097/icl.0000000000001103