title: Efficacy and Safety of Topical 0.05% Cyclosporine Eye Drops in the Treatment of Dry Eye Syndrome: A Systematic Review and Meta-analysis.
abstract: A systematic review was performed to evaluate the safety and efficacy of topical 0.05% cyclosporine in treating patients with dry eye syndrome (DES). Twelve qualified randomized-controlled trials incorporating 1367 patients were analyzed. In comparison to controls, patients who were on topical 0.05% cyclosporine eye drops had lower Ocular Surface Disease Index scores (mean difference [MD]=4.10, 95% CI: 0.25-7.96, P=.04), longer tear film breakup time (MD=2.30 seconds, 95% CI: 0.75-3.86, P=.004), improved Schirmer I scores (MD=2.77 mm/5min, 95% CI: 1.63-3.91, P=.00001), reduced corneal fluorescein staining (standardized mean difference [SMD]=0.61, 95% CI: 0.07-1.15, P=.03), and higher goblet cell densities (SMD=1.68, 95% CI: 0.54-2.81, P=.004). However, there were more adverse effects in the cyclosporine patient group (odds ratio=1.64, 95% CI: 1.17-2.30, P=.004). Topical 0.05% cyclosporine eye drops twice daily significantly improved both the objective and subjective outcomes in DES patients. The study limitations in the clinical, methodological and statistical heterogeneities are discussed.
authors.affiliation: Department of Ophthalmology, Tuen Mun Eye Center and Tuen Mun Hospital, Hong Kong; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Kelvin H
authors.initials: KH
authors.lastname: Wan
authors.affiliation: Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Liu Ling Nethersole Hospital, Hong Kong; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Li Jia
authors.initials: LJ
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital and Alice Ho Liu Ling Nethersole Hospital, Hong Kong; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong. Electronic address: youngla@ha.org.hk.
authors.forename: Alvin L
authors.initials: AL
authors.lastname: Young
mesh_terms: D016572:Cyclosporine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D015352:Dry Eye Syndromes / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D009883:Ophthalmic Solutions; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine
keywords: cornea; cyclosporine; dry eye syndrome; keratoconjunctivitis sicca; meta-analysis; ocular surface; systematic review