title: Topical cyclosporine A for postoperative photorefractive keratectomy and laser in situ keratomileusis.
abstract: OBJECTIVE
  To compare the stability and predictability of the refractive outcomes in eyes treated with photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK) with and without postoperative use of topical cyclosporine A emulsion.
  
  
  METHODS
  Naval Medical Center San Diego Refractive Surgery Center, San Diego, California, USA.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  Patients had PRK or LASIK and were randomized, pairwise, to a standard postoperative treatment regimen with or without the addition of topical cyclosporine A 0.05% emulsion twice daily for 3 months postoperatively. Visual acuity, mesopic contrast acuity, refractions, and ocular symptoms were assessed through the 3-month examination. Tear-film samples (cytokines and chemokines) were analyzed preoperatively and 1 week and 1 and 3 months postoperatively.
  
  
  RESULTS
  The PRK group comprised 70 patients and the LASIK group, 54 patients. The addition of topical cyclosporine A twice a day after PRK or LASIK did not confer special benefits in terms of achievement of target refraction, final uncorrected distance visual acuity (UDVA), or rate of visual recovery (all P>.05, multivariate analysis of variance [MANOVA]). There was no significant difference in tear-film composition based on measurement of matrix metalloproteinase-9, interleukin (IL)-6, or IL-8 recovery (all P>.05, MANOVA).
  
  
  CONCLUSIONS
  The addition of topical cyclosporine A twice daily for 3 months after PRK or LASIK did not provide a significant benefit in the rate of visual recovery, final UDVA, or patient symptoms, nor did it significantly change measured inflammatory mediators (cytokines) present in the tear film.
authors: Naval Hospital Bremerton, Bremerton, Washington 98337, USA. david.hessert@med.navy.mil
authors: David
authors: D
authors: Hessert
authors: David
authors: D
authors: Tanzer
authors: Tyson
authors: T
authors: Brunstetter
authors: Sandor
authors: S
authors: Kaupp
authors: Donna
authors: D
authors: Murdoch
authors: Myah
authors: M
authors: Mirzaoff
mesh_terms: D000287:Administration, Topical; D000328:Adult; D001251:Astigmatism / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D015350:Contrast Sensitivity / Q000187:drug effects / Q000502:physiology; D016572:Cyclosporine / Q000008:administration & dosage*; D016207:Cytokines / Q000378:metabolism; D004655:Emulsions; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D009883:Ophthalmic Solutions; D018903:Photorefractive Keratectomy; D011182:Postoperative Care; D012029:Refraction, Ocular / Q000187:drug effects / Q000502:physiology; D013666:Tears / Q000378:metabolism; D014792:Visual Acuity / Q000187:drug effects* / Q000502:physiology; D055815:Young Adult
chemical_list: D016207:Cytokines; D004655:Emulsions; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine