Long Term Follow-up Results of Topical 0.05% Cyclosporine A in Patient with Dry Eye

To evaluate the therapeutic effects of 0.05% cylosporine A eyedrops (Restasis, Allergan Inc., Irvine, CA, USA.) in patients with dry eye syndrome, one hundred thirty-five patients (270 eyes) with dry eye syndrome were treated with 0.05% cylosporine A (CsA) and lubrication eyedrops for 12 months. Before and 1, 3, 6 and 12 months after treatment, symptom score, corneal sensitivity, tear film break-up time (BUT), keratoepitheliopathy score, basal tear secretion, tear clearance rate were measured. Before and 3 months after treatment, conjunctival impression cytology were done. One month after treatment, symptom score (2.38±0.80), basal tear secretion (6.34±3.26 mm), and keratoepitheliopathy score (1.10±1.54) were improved from 2.87±0.62 (p<0.01), 5.89±2.72 mm (p<0.01) and 1.50±1.82 (p<0.01), respectively. Three months after treatment, tear film break-up time (5.70±1.76 sec) and tear clearance test (13.52±11.0) were improved from 5.24±2.01 sec (p=0.01) and 10.74±8.48 (p=0.02), respectively. Six months after treatment, corneal sensitivity were improved from 57.85±4.27 mm to 57.57±6.24 mm (p=0.01) during the follow up period. Treatment of dry eye syndrome with topical CsA resulted in an increase in goblet cell numbers and decrease in conjunctival keratinization. Fourteen patients (10.4%) were discontinued instillation of topical CsA due to burning sensation and pain. Use of 0.05% topical CsA emulsion is effective for dry eye syndrome in helping to improve ocular symptom, and parameters of tear film and ocular surface during the follow-up period of 12 months.