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A cyclosporin A emulsion improved ocular surface disease index, average non-invasive tear break-up time, and lipid layer thickness after cataract surgery.

Dry eye disease (DED) after cataract surgery has a high prevalence, significantly influencing patient satisfaction. This complication can reduce vision quality and cause patient discomfort. Additionally, DED following surgery is associated with decreased tear secretion and break-up time.

New findings from a retrospective review suggest that 0.1% cyclosporin A cationic emulsion (CsA-CE) may be effective at controlling DED post-cataract surgery, according to results published in Diagnostics.

The researchers reviewed the medical records of patients who underwent simple cataract surgery. Subjective and objective assessments were done at baseline and one month post-surgery. The non-invasive tear meniscus height, non-invasive tear break-up time, conjunctival redness, meibomian gland morphology, and lipid layer thickness were assessed using a Placido tear film analyzer.

All patients used 0.5% moxifloxacin and 1% prednisolone acetate eye drops four times daily post-operatively. The patients were divided into CsA-CE (n=94) and control (n=91) groups based on whether they have used CsA-CE one week after surgery. Preoperative dry eye parameters were comparable between the groups.

CsA-CE Group Shows Improvements in Multiple Outcomes

Overall, the CsA-CE group showed significant improvements in ocular surface disease index, average non-invasive tear break-up time, and lipid layer thickness, reported the authors.

Specifically, the ocular surface disease index decreased from 19.26 to 14.58 (P=0.046) at one month after surgery, indicating an improvement in subjective dry eye symptoms. The average non-invasive tear break-up time rose considerably from 10.97 s preoperatively to 13.00 s postoperatively (P=0.087). The lipid layer thickness also increased significantly from 70.29 to 86.41 nm (P<0.001).

In the control group, conjunctival redness scores increased for nasal bulbar conjunctival hyperemia from 1.49 to 1.88 (P<0.001), but no statistically significant changes were observed in the other parameters. For both groups, nasal limbal hyperemia and overall limbal hyperemia increased (CsA-CE, 1.12 to 1.30; P=0.005 and 1.58 to 1.73; P=0.017; control, 1.12 to 1.50; P=0.001; and 1.69 to 1.96; P=0.012).

“Given its beneficial effects on tear film stability, lipid layer enhancement, and ocular surface protection, CsA-CE is a promising adjunct therapy that may help mitigate the risk of postoperative dry eye symptoms and improve patient comfort and visual outcomes,” wrote the researchers.

However, they noted that the need for additional well-designed, long-term studies with larger sample sizes and double-blind protocols to thoroughly assess its sustained therapeutic benefits and establish its potential as a standard treatment option for post-operative DED.