Short term effects of topical cyclosporine and viscoelastic on the ocular surfaces in patients with dry eye.
OBJECTIVE
To compare the short term effects of topical 0.05% cyclosporine (CsA) and a mixture of 0.08% chondroitin sulfate and 0.06% sodium hyaluronate (CS-HA) on dry eye ocular surfaces.


METHODS
36 patients with moderate to severe dry eye (5 mm/5 min or less with Schirmer's test or tear break up time (BUT) less than 6 seconds), were treated with topical application of CS-HA on one eye and CsA on the other 4 times a day for 6-8 weeks. BUT, Schirmer's test without anesthesia, and conjunctival impression cytology (CIC; goblet cell density, nucleus to cytoplasmic ratio, and epithelial cell morphology) were evaluated and compared between eyes before and after treatment (repeated measurement of ANOVA).


RESULTS
After treatment, BUT and tear wettings were significantly prolonged in each group. Topical CsA treated eyes had greater increase in BUT (p=0.026); there was no significant difference in tear wetting (p=0.132). While the 3 parameters of CIC improved in both groups, goblet cell density was significantly higher in eyes treated with CsA (p=0.033).


CONCLUSIONS
While both CS-HA and 0.05% CsA eyedrops improve ocular surfaces, topical CsA may have a better effect on enhancing tear film stability and goblet cell density.
Department of Ophthalmology, Konkuk University Hospital, Seoul, Korea.
Jun Woong
JW
Moon
Hyun Joo
HJ
Lee
Ki Chul
KC
Shin
Won Ryang
WR
Wee
Jin Hak
JH
Lee
Mee Kum
MK
Kim
D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000287:Administration, Topical; D002452:Cell Count; D002809:Chondroitin Sulfates / Q000008:administration & dosage*; D003228:Conjunctiva / Q000187:drug effects / Q000473:pathology; D016572:Cyclosporine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D004848:Epithelium / Q000187:drug effects / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D020397:Goblet Cells / Q000187:drug effects / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D013666:Tears / Q000187:drug effects / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D004338:Drug Combinations; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine; D006820:Hyaluronic Acid; D002809:Chondroitin Sulfates