Effect of 0.05% Cyclosporine A on the Ocular Surface after Photorefractive Keratectomy

Yong II Kim; Sung Hyun Koo; Sang Won Ha; Gwang Ja Lee; Kyoo Won Lee; Young Jeung Park

doi:10.3341/jkos.2016.57.5.710

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Kim, Koo, Ha, Lee, Lee, and Park: Effect of 0.05% Cyclosporine A on the Ocular Surface after Photorefractive Keratectomy

Original Article

J Korean Ophthalmol Soc 2015;57(5):710-717.

Published online: 7 September 2015

DOI: https://doi.org/10.3341/jkos.2016.57.5.710

Effect of 0.05% Cyclosporine A on the Ocular Surface after Photorefractive Keratectomy

Yong II Kim, MD¹, Sung Hyun Koo, MD², Sang Won Ha, MD¹, Gwang Ja Lee, MD¹, Kyoo Won Lee, MD, PhD¹, Young Jeung Park, MD, PhD¹

¹Cheil Eye Hospital, Daegu, Korea

²Department of Ophthalmology, Dongkang Medical Center, Ulsan, Korea

Address reprint requests to Young Jeung Park, MD, PhD Cheil Eye Hospital, #1 Ayang-ro, Dong-gu, Daegu 41196, Korea Tel: 82-53-959-1751, Fax: 82-53-959-1758 E-mail: eyepark9@naver.com

Received 3 September 201517 December 2015 Accepted 5 February 2016

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 perm its unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effect of 0.05% cyclosporine A on the ocular surface after photorefractive keratectomy (PRK).

Methods

This retrospective study included 50 patients who underwent PRK. Patients were divided into two groups: 25 patients in group I were treated with topical 0.05% cyclosporine A with conventional medication, and 25 patients in group II were treated with conventional medication. Visual acuity (VA), tear break-up time (BUT), fluorescein staining score (F-stain), Schirmer I test, and ocular surface disease index (OSDI) were evaluated before surgery and 2 weeks, 1 month, 2 months, and 3 months after surgery.

Results

F-stain was significantly lower in group I than in group II at 2 weeks and 1 month (p< 0.05). There was no significant difference in uncorrected VA, BUT, Schirmer I test, or OSDI between the groups. However, group I showed a more effective pattern in dry eye.

Conclusions

Combination treatment with 0.05% cyclosporine A was helpful for early ocular surface stability in patients with dry eye after PRK.

Keywords: Cyclosporine A, Dry eye, Ocular surface stability, Photorefractive keratectomy, Refractive surgery

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Figure 1.

Comparison of uncorrected visual acuity between the groups over time. (A) Group I and group II show a significant difference compared to preoperative values during the follow-up period (compared with preoperative value by repeated measure analysis of variance [ANOVA]). (B) There was no statistically significant difference between the groups (compared by Mann-Whitney U-test). Group I = conventional treatment + 0.05% cyclosporine A; Group II = conventional treatment. ∗p < 0.05.

Figure 2.

Comparison of tear break-up time between the groups over time. (A) Group I shows a significant difference at 2 weeks compared with preoperative value, and group II at 2 weeks and 1 month (p < 0.05, compared with preoperative value by repeated measure analysis of variance [ANOVA]). (B) There is no statistically significant difference between the groups during the follow-up period (compared by Student’s t-test). Group I = conventional treatment + 0.05% cyclosporine A; Group II = conventional treatment. ∗p < 0.05.

Figure 3.

Comparison of fluorescein staining score between the groups over time. (A) Group I shows a significant difference at 2 weeks compared with preoperative value, and group II at 2 weeks and 3 months (p < 0.05, compared with preoperative value by repeated measure analysis of variance [ANOVA]). (B) There is a statistically significant difference between the groups at 2 weeks and 1 month (p < 0.05, compared by Student’s t-test). Group I = conventional treatment + 0.05% cyclosporine A; Group II = conventional treatment. ∗p < 0.05.

Figure 4.

Comparison of Schirmer I test between the groups over time. (A) Group I and group II shows no significant difference during the follow-up period compared with preoperative values (compared with preoperative value by repeated measure analysis of variance [ANOVA]). (B) There is no statistically significant difference between the groups during the follow-up period (compared by Student’s t-test). Group I = conventional treatment + 0.05% cyclosporine A; Group II = conventional treatment.

Figure 5.

Comparison of ocular surface disease index between the groups over time. (A) Group I and group II shows no significant difference during the follow-up period compared with preoperative value (compared with preoperative value by repeated measure analysis of variance [ANOVA]). (B) There is no statistically significant difference between the groups during the follow-up period (compared by Student’s t-test). Group = conventional treatment + 0.05% cyclosporine A; Group I = conventional treatment + 0.05% cyclosporine A; Group II = conventional treatment.

Table 1.

Demographics of the study groups

	Group I	Group II	p-value
Number of eyes	25	25
Patients (male:female)	10:15	8:17	0.556^∗
Mean age (years)	25.4 ± 6.6	25.8 ± 5.3	0.523^†
Uncorrected visual acuity (log MAR)	1.06 ± 0.32	1.15 ± 0.20	0.693^†
Best corrected visual acuity (log MAR)	0	0	1.000^†
Spherical equivalent (diopter)	-4.86 ± 2.27	-5.17 ± 2.45	0.352^‡
Ablation depth (μm)	83.28 ± 30.70	87.33 ± 26.67	0.245^‡
Ablation diameter (mm)	6.54 ± 0.30	6.45 ± 0.31	0.589^‡
Tear BUT (second)	6.64 ± 2.62	6.56 ± 2.95	0.920^‡
F-stain	0.64 ± 0.91	0.72 ± 1.21	0.792^‡
Schirmer I test (mm)	11.93 ± 5.71	12.40 ± 10.67	0.832^‡
OSDI	24.78 ± 12.80	23.74 ± 16.07	0.696^‡

Values are presented as mean ± SD unless otherwise indicated. ‘Group I’ is ‘conventional treatment + 0.05 % cyclosporine A and ‘Group II’ is ‘conventional treatment’.

BUT = break-up time; F-stain = fluorescein staining score; OSDI = ocular surface disease index.

^∗ Chi-square test;

^† Mann-Whitney U-test;

^‡ Student’s t-test.

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