Efficacy of commercially available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction.
OBJECTIVE
To investigate the efficacy of topical cyclosporine A 0.05% (tCsA) (Restasis, Allergan Pharmaceuticals) in the treatment of meibomian gland dysfunction (posterior blepharitis).


METHODS
Thirty-three patients with symptomatic meibomian gland dysfunction were randomized in a prospective study to either tCsA or placebo (Refresh Plus preservative-free artificial tears), 2 times daily for 3 months. They were evaluated at baseline and at 1, 2, and 3 months for subjective symptoms and objective signs including meibomian gland inclusions, lid margin vascular injection, tarsal telangiectasis, fluorescein staining, tear breakup time, and Schirmer scores.


RESULTS
Twenty-six patients completed the study. All patients were tested for ocular symptoms, lid margin vascularity, tarsal telangiectasis, meibomian gland inclusions, tear breakup time, and fluorescein staining. At the 3-month visit, the tCsA group showed a greater improvement in ocular symptoms than the placebo group, but this difference was not statistically significant. At the 3-month visit, several objective examination findings were statistically significantly (P < 0.05) improved in the tCsA group compared with the placebo group. These differences included lid margin vascular injection, tarsal telangiectasis, and fluorescein staining. The most significant finding (P = 0.001) was the greater decrease in the number of meibomian gland inclusions in the tCsA group compared with the placebo group.


CONCLUSIONS
Topical CsA may be helpful in the treatment of meibomian gland dysfunction (posterior blepharitis). Topical CsA did not induce an improvement in the symptoms, but it did decrease the number of meibomian gland inclusions in patients with meibomian gland dysfunction.
Perry
Henry D
HD
Ophthalmic Consultants of Long Island, Rockville Centre, New York 11570, USA. hankcornea@aol.com
Doshi-Carnevale
Sima
S
Donnenfeld
Eric D
ED
Solomon
Renée
R
Biser
Seth A
SA
Bloom
Adam H
AH
D000328:Adult; D001762:Blepharitis / Q000188:drug therapy* / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage* / Q000627:therapeutic use; D019793:Fluorescein / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D008537:Meibomian Glands / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism; D016896:Treatment Outcome
D003287:Contrast Media; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine; D019793:Fluorescein