PURPOSE:
To compare the efficacy of topical cyclosporine [0.05% cyclosporine A (CsA)] and preservative-free artificial tears in the treatment of meibomian gland dysfunction (MGD).
METHODS:
A 3-month prospective, randomized, double-masked, parallel-group controlled trial enrolled 70 patients with symptomatic MGD and unstable tear film [tear breakup time (TBUT) < 8 seconds]. Patients were randomized to topical CsA (0.05%; group A) and 0.5% carboxymethylcellulose (control; group B) instilled twice daily for 3 months. Ocular Surface Disease Index (OSDI), lid margin inflammation, meibomian gland expression, conjunctival injection, corneal and interpalpebral dye staining, noninvasive tear breakup time (NIBUT) using the Tearscope Plus and invasive fluorescein tear breakup time (FBUT), and Schirmer I test were performed.
RESULTS:
At the 3-month evaluation, mean OSDI, NIBUT and FBUT, lid margin inflammation, meibomian gland expressibility, and tarsal injection showed significant improvement from baseline in group A (P < 0.01, P < 0.01, P < 0.001, P < 0.05, and P < 0.001, respectively). In group B, only the OSDI improved significantly from baseline at 3 months (P = 0.003). TBUTs (NIBUT and FBUT) were significantly longer in group A at all visits, and the mean change of TBUTs from baseline was also significantly greater in group A at 3 months (P < 0.001).
CONCLUSIONS:
Topical CsA 0.05% twice daily may be helpful in the treatment of MGD mainly by improving tear film stability.
Cornea. 2012 Dec;31(12):1386-93. doi:
10.1097/ICO.0b013e31823cc098.
Prabhasawat P,
Tesavibul N,
Mahawong W.
Department of Ophthalmology, Faculty of Medicine, Siriraj
Hospital, Mahidol University, Bangkok, Thailand. sippb@mahidol.ac.th
1 comment:
I've tried Restasis 2 seperate times--both for at least 6 months. Restasis works by stopping the cycle of inflammation, which in some cases may be enough to produce better quality tears. In my case, it failed to even stop inflammation. I've found that other medications have worked better to stop the inflammation caused by dry eye including Naproxen Sodium, ibuprofen and even some prescription medication such as Meloxicam. But Inflammation in itself does not CAUSE dry eye. It is a SYMPTOM of dry eye (although inflammation does magnify the condition). So stopping inflammation (or the "cycle" of inflammation) does not CURE dry eye. If this were the case, I would be surely by cured by Meloxicam. I am waiting for something to come along that actually gets to the ROOT of dry eye....
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