ABSTRACT
AIM: To assess the effect of cyclosporine-A (CsA) 0.05% ophthalmic emulsion on corneal sensation and ocular surface problems following cataract surgery. DESIGN: 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.
Subject(s)
Cataract Extraction/adverse effects , Cornea/innervation , Cyclosporine/administration & dosage , Postoperative Care/methods , Postoperative Complications/drug therapy , Sensation/drug effects , Adult , Aged , Aged, 80 and over , Cornea/drug effects , Double-Blind Method , Female , Follow-Up Studies , Humans , Immunosuppressive Agents/administration & dosage , Male , Middle Aged , Ophthalmic Solutions , Postoperative Complications/physiopathology , Prospective Studies , Visual Acuity , Young AdultABSTRACT
We report the refractive correction of high astigmatism in one eye of a 23-year-old woman following deep anterior lamellar keratoplasty (DALK) using an Artisan iris-fixated, toric, phakic intraocular lens (IOL). One year after implantation, uncorrected and corrected distance visual acuities were both 20/25, refraction was -1.00 D cylinder, and the endothelial cell count was 1827 cells/mm(2). Iris-fixated phakic IOLs are not recommended for every postkeratoplasty patient with high refractive error; however, this procedure can offer good outcomes in carefully selected cases of previous DALK.
