The Dry Eye Zone

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Abstract: Which patients does Restasis help?

Very interesting - thank you! At last something breaking down results by dry eye severity level. This one seems to say, the mild-to-moderate dry eye patients are much more likely to benefit from cyclosporine 0.05% than the severe ones.

Evaluation of the effect of topical cyclosporine A with impression cytology in dry eye patients.
Eur J Ophthalmol. 2010 Feb 1. [Epub ahead of print]
Yüksel B, Bozdag B, Acar M, Topaloglu E.
Eye Bank and Cornea Section, Izmir Bozyaka Teaching and Research Hospital, Bozyaka-Izmir - Turkey.

Purpose. This study evaluated the efficacy of topical cyclosporine A 0.05% treatment with impression cytology in dry eye patients.

Methods. Forty eyes of 40 patients with dry eye were included. Schirmer, tear break-up time, and Ocular Surface Disease Index (OSDI) scores and goblet cell densities were noted before and after 6 months of topical cyclosporine A treatment. Patients were graded clinically and biomicroscopically as follows: grade 1, 12 patients; grade 2, 18; and grade 3, 10 patients.

Results. Mean age was 57.1 plusmn;11.8 (23.0 ndash;80.0) years. A total of 36 (90%) of the patients were female and 4 (10%) were male. Mean Schirmer test value was 3.2 plusmn;1.6 (0.0 ndash;8.0) mm in the beginning and was 8.4 plusmn;4.3 (1.0 ndash;19.0) mm after 6 months of cyclosporine A topical treatment (p=0.00). At the first visit, mean tear break-up time was 4.4 plusmn;1.8 (2.0 ndash;8.0) seconds. It increased to 11.8 plusmn;4.8 (2.0 ndash;20.0) seconds at the end of the sixth month (p=0.00). Mean clinical grading was 1.9 plusmn;0.8 (1.0 ndash;3.0) and this value regressed to 0.8 plusmn;1.2 (0.0 ndash;3.0) after the treatment (p=0.00). Mean OSDI score was 30.0 plusmn;11.7 (9.0 ndash;50.0) before the treatment and 21.3 plusmn;11.0 (4.0 ndash;47.0) after the treatment (p=0.00). Mean goblet cell density of all cases was 12.3 plusmn;8.7 before the treatment (2.0 ndash;28.0). It increased to 33.0 plusmn;25.4 (6 ndash;70) after the treatment (p=0.04).

Conclusions. Topical cyclosporine A treatment is effective in grade 1 and grade 2 dry eye patients but results are poor in grade 3 patients.
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