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Abstract
Purpose
To evaluate the efficacy of topical cyclosporine A 0.05% (Restasis) in the treatment of dry eye symptoms caused by various ocular surface inflammatory disorders.
Methods
Thirty‐ three patients with ocular surface diseases, including 17 with Sjögren syndrome, 8 with meibomian gland dysfunction (MGD), 4 with Thygeson's keratitis, and 4 with atopic keratoconjunctivitis (AKC) were treated with Restasis twice a day for 3 months. During follow‐ up, the symptom severity assessment (burning, itching, foreign body sensation, blurring, photophobia, and pain), TBUT (tear break‐ up time), Schirmer score, frequencies of artificial tear use, onset of symptomatic relief, subjective satisfaction score, and side effects were evaluated.
Results
In patients with Sjögren syndrome, foreign body sensation, blurring, photophobia, and pain were reduced after treatment, and the mean Schirmer score, TBUT increased and frequencies of artificial tear use decreased significantly. In patients with MGD, photophobia was reduced after treatment, TBUT and artificial tear use improved after 2 months, and the Schirmer score increased at 3 months. In patient's with Thygeson's keratitis, foreign body sensation and photophobia reduced, and the Schirmer score was increased at 3 months. No significant changes in symptoms, Schirmer score, or TBUT were observed in patients with AKC. Of all subjects, 55% reported symptomatic relief between 3 and 5 weeks after treatment. The mean satisfaction score after treatment was the highest for patients with Sjögren syndrome. Two subjects reported a temporary burning sensation, and one subject quit using Restasis because of bitter taste and a burning sensation.
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Figure 1.
Change in symptom severity ratings before and after Restasis treatment. Six Ocular symptoms (burning, itching, foreign body sensation, blurring, photophobia, pain) were graded from 0 to 4 depending on severity. Average ratings according to patient groups: (A)=Sjogren syndrome; (B)=MGD (Meibomian gland dysfunction); (C)=Thygeson keratitis; (D)=atopic keratoconjunctivitis. (＊ significantly different from pretreatment, p<0.05)
Figure 2.
Change of mean schirmer score before and after Restasis treatment.＊ Significantly different from pretreatment, p<0.05.
Figure 3.
Change of TBUT before and after Restasis treatment.＊ Significantly different from pretreatment, p<0.05.
Figure 4.
Change of frequencies of artificial tear instillation per day before and after Restasis treatement.＊ Significantly different from pretreatment, p<0.05.
Figure 5.
Distribution by time from treatment initiation to experience of symptom relief after Restasis instillation.
Figure 6.
Mean subjective satisfaction score (0 to 10) after completion of 3-month Restasis treatment.
Table 1.
Patient demograophics
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