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Jeon, Kim, Jung, Yoon, Seo, Lee, Kim, and Kim: Effect of Cyclosporin A on Tear Film and Corneal Aberration after Cataract Surgery
Original Article

J Korean Ophthalmol Soc 2014;55(7):978-983.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.7.978

Effect of Cyclosporin A on Tear Film and Corneal Aberration after Cataract Surgery

Jei Hun Jeon, MD, Hong Seok Kim, MD, Ji Won Jung, MD, Sang Chul Yoon, MD, Kyoung Yul Seo, MD, PhD, Hyung Keun Lee, MD, Eung Kweon Kim, MD, PhD, Tae Im Kim, MD, PhD

The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Tae Im Kim, MD, PhD, Department of Ophthalmology, Severance Hospital, #50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea, Tel: 82-2-2228-3570, Fax: 82-2-312-0541, E-mail: TIKIM@yuhs.ac

Received 13 December 2013       Revised 7 January 2014       Accepted 2 June 2014

Copyright © 2014 The Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the efficacy of 0.05% cyclosporine A on tear film parameters and corneal aberration after cataract surgery.

Methods

Patients who underwent cataract surgery were divided into 2 groups. Patients in Group I (23 eyes) were treated with cyclosporine A from 1 week before surgery to 3 months after surgery. Patients in Group II (24 eyes) underwent surgery without cyclosporine treatment. Tear film break-up time (BUT), Schirmer's test I, Oxford scheme, Ocular surface disease index (OSDI), and corneal aberrations were evaluated before surgery and at 1 and 3 months after surgery.

Results

In Group I, BUT was significantly improved at 3 months (p = 0.026) after surgery compared with the preoperative value. OSDI decreased significantly at 1 (p = 0.033) and 3 months (p = 0.003) after surgery compared with the preoperative value. However, there were no significant differences between preoperative and postoperative values of BUT and OSDI in Group II. Schirmer's test results and the Oxford scheme were not significantly changed in either group. Preoperative root mean square (RMS) total values were not different between the 2 groups, but was different at postoperative 3 months (p = 0.015). Group I had a significantly lower value for total RMS than Group II. In Group I, Coma 7 (Z3-1) (p = 0.018) and spherical aberration (Z40) (p = 0.031) were significantly decreased after surgery. In Group II, Trefoil 6 (Z3-3) (p = 0.033) was significantly increased after surgery.

Conclusions

0.05% cyclosporine A may be effective for improving dry eye syndrome and corneal aberration after cataract surgery.

Keywords: Cataract surgery, Corneal aberration, Cyclosporin, Dry eye

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Figure 1.
Changes of corneal aberrations in each group during follow up. In Group I, Coma 7 (Z3-1), spherical aberration (Z40) were significantly decreased after surgery. In Group II, Trefoil 6 (Z3-3) was significantly increased after surgery. Asterisks mean p < 0.05 compared with preoperative values. RMS = root mean square; HOA = higher order aberrations.
jkos-55-978f1.tif
Table 1.
Patients demographics and variables of tear film in the 2 groups
Group I (n = 23) Group II (n = 24) p-value*
Age (years) 67.7 ± 10.6 64.8 ± 9.6 0.141
Male (%) 20.5 15.9 0.683
BUT (sec)
  Preoperative 5.9 ± 1.0 5.9 ± 1.1 0.778
  Postoperative 1 month 6.2 ± 1.5 5.9 ± 1.3 0.527
  Postoperative 3 months 7.0 ± 1.7† 6.3 ± 1.8 0.178
Schirmer test (mm/5 min)
  Preoperative 10.6 ± 2.4 12.0 ± 2.6 0.082
  Postoperative 1 month 11.1 ± 2.4 11.2 ± 3.4 0.804
  Postoperative 3 months 10.6 ± 1.5 10.9 ± 3.2 0.501
OSDI (total score)
  Preoperative 20.0 ± 27.8 10.1 ± 24.3 0.051
  Postoperative 1 month 8.9 ± 14.8† 6.1 ± 9.3 0.783
  Postoperative 3 months 2.4 ± 5.6† 7.7 ± 10.6 0.092
Oxford Scheme
  Preoperative 1.0 ± 0.6 0.8 ± 0.8 0.208
  Postoperative 1 month 0.9 ± 0.8 0.7 ± 0.7 0.351
  Postoperative 3 months 0.8 ± 0.6 0.6 ± 0.7 0.176

Values are presented as mean ± SD.

BUT = tear film break-up time; OSDI = ocular surface disease index.

* Indicated differences between two groups;

† Means p < 0.05 compared with preoperative values.

Table 2.
Differences of corneal aberrations between groups at each follow-up point
Group I (n = 23) Group II (n = 24) p-value
RMS Total
  Preoperative 0.005 ± 0.213 0.021 ± 0.214 0.741
  Postoperative 1 month -0.019 ± 0.181 0.039 ± 0.182 0.050
  Postoperative 3 months -0.052 ± 0.127 0.078 ± 0.173 0.015*
HOA
  Preoperative 0.023 ± 0.166 0.037 ± 0.032 0.774
  Postoperative 1 month 0.068 ± 0.221 0.073 ± 0.159 0.966
  Postoperative 3 months 0.023 ± 0.227 0.080 ± 0.136 0.911
Coma 7, Z3-1
  Preoperative 0.021 ± 0.111 0.087 ± 0.148 0.259
  Postoperative 1 month 0.011 ± 0.177 0.067 ± 0.129 0.750
  Postoperative 3 months 0.003 ± 0.092 0.069 ± 0.117 0.103
Coma 8, Z31
  Preoperative 0.003 ± 0.070 -0.001 ± 0.091 0.856
  Postoperative 1 month 0.005 ± 0.089 0.009 ± 0.088 0.496
  Postoperative 3 months -0.005 ± 0.053 0.013 ± 0.057 0.491
Trefoil 6, Z3-3
  Preoperative -0.089 ± 0.086 -0.142 ± 0.196 0.694
  Postoperative 1 month -0.090 ± 0.111 -0.089 ± 0.166 0.503
  Postoperative 3 months -0.086 ± 0.200 -0.080 ± 0.156 0.855
Trefoil 9, Z3+3
  Preoperative 0.012 ± 0.080 0.009 ± 0.092 0.371
  Postoperative 1 month 0.051 ± 0.097 0.022 ± 0.089 0.099
  Postoperative 3 months 0.033 ± 0.060 0.028 ± 0.081 0.509
Spherical aberration, Z40
  Preoperative 0.080 ± 0.024 0.081 ± 0.046 0.580
  Postoperative 1 month 0.077 ± 0.042 0.068 ± 0.031 0.209
  Postoperative 3 months 0.060 ± 0.028 0.067 ± 0.027 0.643

Values are presented as mean ± SD.

RMS = root mean square; HOA = higher order aberrations.

* Means p < 0.05 compared between two groups.

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