Assessment of the effect of cyclosporine-A 0.05% emulsion on the ocular surface and corneal sensation following cataract surgery.
OBJECTIVE
To assess the effect of cyclosporine-A (CsA) 0.05% ophthalmic emulsion on corneal sensation and ocular surface problems following cataract surgery.


METHODS
Prospective, randomized, double masked clinical trial.


METHODS
Consecutive case series of patients attending for bilateral cataract surgery. Subject's eyes were randomized to receive either topical CsA or carboxymethylcellulose 0.5% (CMC) eye drops twice daily for one month following routine cataract surgery. Subjective and objective assessments were performed pre-operatively, one week, and one month after surgery. Primary safety parameters included best spectacle-corrected visual acuity and incidence of adverse events. Objective assessments included tests of tear film (osmolarity, tear break-up time, and Schirmer's type-I test), ocular surface staining, corneal sensitivity and a subjective assessment: ocular surface disease index (OSDI) questionnaire.


RESULTS
30 subjects (60 eyes) were recruited. At one month following cataract surgery, osmolarity, ocular surface staining, TBUT, Schirmer's results showed a greater improvement after CsA drops compared to CMC and this was statistically significant for all measures (p<0.05). All corneal sensation measurements were reduced after one week and one month. Eyes receiving CsA had higher recovery of corneal sensation at both time points post operatively and this was statistically significant at one month. OSDI questionnaire results did not show a statistically significant difference between the two eyes.


CONCLUSIONS
CsA is effective and safe in the management of ocular surface problems after cataract surgery and allows faster recovery of corneal sensation. This recovery of sensation may be relevant to the improvement in ocular surface problems in all patients.
School of Biomedical Sciences, University of Ulster, Coleraine, NI, UK; Birmingham and Midland Eye Centre, Birmingham, UK; Corneo Plastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK.
Samer
S
Hamada
School of Biomedical Sciences, University of Ulster, Coleraine, NI, UK.
Tara C B
TC
Moore
School of Biomedical Sciences, University of Ulster, Coleraine, NI, UK; Cathedral Eye Clinic, Belfast, NI, UK.
Jonathan E
JE
Moore
Manar International Hospital, Damascus, Syria.
Madonna G
MG
Al-Dreihi
Corneo Plastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK; Manar International Hospital, Damascus, Syria.
Anas
A
Anbari
School of Biomedical Sciences, University of Ulster, Coleraine, NI, UK; Birmingham and Midland Eye Centre, Birmingham, UK; Midland Eye, Solihull, UK. Electronic address: sunilshah@doctors.net.uk.
Sunil
S
Shah
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D003315:Cornea / Q000187:drug effects / Q000294:innervation*; D016572:Cyclosporine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D012677:Sensation / Q000187:drug effects*; D014792:Visual Acuity; D055815:Young Adult
D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine
Anti-inflammatory; Cataract surgery; Corneal nerves recovery; Corneal sensation; Cyclosporine-A; Ocular surface