Adnan Ahmad, Mubashir Rehman, Hamid Rehman.
Evaluating the Pharmacological Effectiveness and Local Side Effects of Topical Cyclosporine a 0.05% in Ocular Dryness Resistant to Lubricating Drops.
Al-Shifa J Ophthalmol Jan ;17(4):157-64.

Objective: To assess the therapeutic response and safety of topical cyclosporine A (Cs-A) 0.05% in ocular dryness resistant to topical lubricants. Material and Methods: An interventional case series study was performed on the participants recruited from Eye OPD of Qazi Hussain Medical Complex, Nowshera from Sept. till Nov. 2019. All the patients were suffering from ocular dryness, resistant to standard therapy with topical lubricants. Topical cyclosporine A 0.05% was used twice daily. The participants were assessed at baseline, 4th week, 12th week and at 26th week. During these follow ups participants were examined for any changes from baseline with regard to Schirmer test, rose Bengal and fluorescein staining of ocular surface, tear film break up time (TBUT), ocular surface disease index (OSDI) and visual acuity. Results: Mean age was 57.1 +- 11.8 (35.0 -80.0) years. A total of 30 (90%) of the patients were female and 6 (10%) were male. Mean Schirmer`s test value was 4.0 +- 0.8 (0.5-10.0) mm at baseline and raised to 9.0 +- 3.8 (2.6-18.8) mm post therapy at 26th week (p =0.001). At the first visit, mean tear break-up time was 4.4 +- 1.8 (2-9) seconds. It increased to 11.8 +- 4.8 (4-22) seconds at the end of 26th week (p =0.001). Mean clinical score at baseline was 2.0 +- 1.0 (1.0-3.0) and this dropped down to 1.0 +- 0.8 (0-3) post therapy (p=0.001), similarly mean OSDI score was 31.2 +- 10.5 (10-52) before the treatment and 21.3 +- 11.0 (5-45) post therapy (p=0.001). Visual acuity also improved significantly after 26th week of therapy (p=0.01). No side effects were reported with topical therapy other than transient ocular burning and itching that resolved after a week of its initiation. Conclusion: Topical cyclosporine A 0.05% is found to be therapeutically effective yet without having any local or systemic toxicity in management of dry eye disease refractory/resistant to conventional treatment.

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