Efficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular pain
Abstract Background The management of post-refractive surgery dry eye disease (DED) can be challenging in clinical practice, and patients usually show an incomplete response to traditional artificial tears, especially when it is complicated with ocular pain. Therefore, we aim to investigate the effi...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-024-03294-z |
| _version_ | 1827235602472370176 |
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| author | Lu Zhao Jiawei Chen Hongyu Duan Tingting Yang Baikai Ma Yifan Zhou LinBo Bian Xiying Cai Hong Qi |
| author_facet | Lu Zhao Jiawei Chen Hongyu Duan Tingting Yang Baikai Ma Yifan Zhou LinBo Bian Xiying Cai Hong Qi |
| author_sort | Lu Zhao |
| collection | DOAJ |
| description | Abstract Background The management of post-refractive surgery dry eye disease (DED) can be challenging in clinical practice, and patients usually show an incomplete response to traditional artificial tears, especially when it is complicated with ocular pain. Therefore, we aim to investigate the efficacy of combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment in post-refractive surgery DED patients with ocular pain unresponsive to traditional artificial tears. Methods We enrolled 30 patients with post-refractive surgery DED with ocular pain who were unresponsive to traditional artificial tears. Topical 0.05% cyclosporine A and 0.1% sodium hyaluronate were used for 3 months. They were evaluated at baseline and 1 and 3 months for dry eye and ocular pain symptoms and objective parameters, including Numerical Rating Scale (NRS), Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-Eye), tear break-up time (TBUT), Schirmer I test (SIt), corneal fluorescein staining (CFS), corneal sensitivity, and corneal nerve morphology. In addition, tear levels of inflammatory cytokines and neuropeptides were measured using the Luminex assay. Results After 3 months of treatment, patients showed a statistically significant improvement in the ocular surface disease index (OSDI), TBUT, SIt, CFS, and corneal sensitivity (all P < 0.01) using linear mixed models. As for ocular pain parameters, the NRS and NPSI-Eye scores were significantly reduced (both P < 0.05) and positively correlated with the OSDI and CFS scores. Additionally, tear IL-1β, IL-6, and TNF-α levels were improved better than pre-treatment (P = 0.01, 0.03, 0.02, respectively). Conclusion In patients with post-refractive surgery DED with ocular pain, combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment improved tear film stability, dry eye discomfort, and ocular pain, effectively controlling ocular inflammation. Trial registration Registration number: NCT06043908. |
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| id | doaj.art-a496f42c6bd44132a99b9f54541ca24a |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2025-03-21T20:07:44Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
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| series | BMC Ophthalmology |
| spelling | doaj.art-a496f42c6bd44132a99b9f54541ca24a2024-06-02T11:12:17ZengBMCBMC Ophthalmology1471-24152024-01-0124111010.1186/s12886-024-03294-zEfficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular painLu Zhao0Jiawei Chen1Hongyu Duan2Tingting Yang3Baikai Ma4Yifan Zhou5LinBo Bian6Xiying Cai7Hong Qi8Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third HospitalInstitute of Medical Technology, Peking University Health Science CenterDepartment of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third HospitalDepartment of Ophthalmology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences, Southern Medical UniversityDepartment of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third HospitalDepartment of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third HospitalDepartment of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third HospitalPeking University First HospitalDepartment of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third HospitalAbstract Background The management of post-refractive surgery dry eye disease (DED) can be challenging in clinical practice, and patients usually show an incomplete response to traditional artificial tears, especially when it is complicated with ocular pain. Therefore, we aim to investigate the efficacy of combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment in post-refractive surgery DED patients with ocular pain unresponsive to traditional artificial tears. Methods We enrolled 30 patients with post-refractive surgery DED with ocular pain who were unresponsive to traditional artificial tears. Topical 0.05% cyclosporine A and 0.1% sodium hyaluronate were used for 3 months. They were evaluated at baseline and 1 and 3 months for dry eye and ocular pain symptoms and objective parameters, including Numerical Rating Scale (NRS), Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-Eye), tear break-up time (TBUT), Schirmer I test (SIt), corneal fluorescein staining (CFS), corneal sensitivity, and corneal nerve morphology. In addition, tear levels of inflammatory cytokines and neuropeptides were measured using the Luminex assay. Results After 3 months of treatment, patients showed a statistically significant improvement in the ocular surface disease index (OSDI), TBUT, SIt, CFS, and corneal sensitivity (all P < 0.01) using linear mixed models. As for ocular pain parameters, the NRS and NPSI-Eye scores were significantly reduced (both P < 0.05) and positively correlated with the OSDI and CFS scores. Additionally, tear IL-1β, IL-6, and TNF-α levels were improved better than pre-treatment (P = 0.01, 0.03, 0.02, respectively). Conclusion In patients with post-refractive surgery DED with ocular pain, combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment improved tear film stability, dry eye discomfort, and ocular pain, effectively controlling ocular inflammation. Trial registration Registration number: NCT06043908.https://doi.org/10.1186/s12886-024-03294-zPost-refractive surgery dry eye diseaseOcular painCyclosporine ASodium hyaluronateOcular inflammationTear film stability |
| spellingShingle | Lu Zhao Jiawei Chen Hongyu Duan Tingting Yang Baikai Ma Yifan Zhou LinBo Bian Xiying Cai Hong Qi Efficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular pain BMC Ophthalmology Post-refractive surgery dry eye disease Ocular pain Cyclosporine A Sodium hyaluronate Ocular inflammation Tear film stability |
| title | Efficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular pain |
| title_full | Efficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular pain |
| title_fullStr | Efficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular pain |
| title_full_unstemmed | Efficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular pain |
| title_short | Efficacy of topical 0.05% cyclosporine A and 0.1% sodium hyaluronate in post-refractive surgery chronic dry eye patients with ocular pain |
| title_sort | efficacy of topical 0 05 cyclosporine a and 0 1 sodium hyaluronate in post refractive surgery chronic dry eye patients with ocular pain |
| topic | Post-refractive surgery dry eye disease Ocular pain Cyclosporine A Sodium hyaluronate Ocular inflammation Tear film stability |
| url | https://doi.org/10.1186/s12886-024-03294-z |
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