Topical Cyclosporine (0.05%) for Management of Dry Eyes in Patients Undergoing Cataract Surgery-A Comparative Study

Abstract

© 2019 Kanclerz et al. Purpose: To assess the efficacy of topical cyclosporine 0.05% in the management of cataract surgery induced dry eye. Methods: This prospective, comparative, randomized, interventional study included 67 patients undergoing cataract surgery. The patients were randomized into three categories Group A: Patients on topical lubricants and cyclosporine 0.05%, Group B: Patients on topical lubricants only and Group C: Patients not on any dry eye medication. Patients were given the respective treatment 2 weeks prior and 3 months after cataract surgery, along with an identical perioperative regimen of topical steroids, antibiotics and NSAIDs. Dry eye evaluation done 2 weeks pre-op, 1 week post-op and 3 months post-op consisted of a subjective questionnaire, tear osmolarity, Tear Break Up Time (TBUT) and Schirmer’s 1 without and with anaesthesia. Results: Pre-operatively, all the 3 groups were matched in terms of mean age, tear osmolarity, TBUT and Schirmer’s 1 without and with anaesthesia scores. At 3 months, patients treated with both topical lubricants and cyclosporine (0.05%)(Group A) showed improvement subjective questionnaire, tear osmolarity, TBUT and Schirmer’s 1 tests. Patients treated with lubricants only (Group B) showed a significant worsening in TBUT and tear osmolarity at 1 week, however, the values returned to baseline at 3 months.The control group (Group C) had the worst TBUT scores at the end of 3 months and showed the persistence of raised tear osmolarity, suggestive of a prolonged ocular inflammation resulting in patient dissatisfaction. Conclusion: Topical cyclosporine (0.05%) may be a useful adjuvant to prevent and treat cataract surgery associated with dry eye symptoms, especially in patients with pre-existing dry eye disease.