Impact of Topical Cyclosporine-A or Topical Chloroquine on Post-LASIK Ocular Surface Stability – A Randomized Controlled Trial

Titiyal, Jeewan S; Goswami, Ananya; Kaur, Manpreet; Sharma, Namrata; Maharana, Prafulla K.; Velpandian, T.; Pandey, Ritu

doi:10.1080/02713683.2023.2182747

Cited by 3 publications

(7 citation statements)

References 23 publications

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“…Gong et al (2022) lacked information on the bias due to the randomization process but overall demonstrated low concerns in other areas, with a few aspects raising some concern regarding reported outcomes [50]. for bias [53,58,62]. Yet, a few areas raised some concerns in certain studies, such as Hessert et al ( 2013), which displayed some concerns regarding the measurement of outcomes [59].…”

Section: Resultsmentioning

confidence: 99%

“…After duplicates were removed, 531 articles were evaluated based just on their title and abstract; 106 of them were rejected. Reports assessed the remaining 425 papers' eligibility (18 were selected in the end for the full-text review out of a total of 216) [48,49,[50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65].…”

Section: Data Extractionmentioning

confidence: 99%

“…Acan and Kurtgoz (2017) and Titiyal et al (2023) investigated the influence of underlying conditions on dry eye parameters [54,58]. Acan and Kurtgoz (2017) emphasized altered tear film stability and ocular surface changes in patients with depression and/or anxiety disorders using selective serotonin reuptake inhibitors [54].…”

Section: Associations Between Dry Eye and Risk Factorsmentioning

confidence: 99%

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Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Dossari

2024

Cureus

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Dry eye disease frequently manifests following corneal refractive procedures, significantly impacting patients' quality of life. This review systematically synthesizes current evidence on the pathophysiological mechanisms, risk factors, and therapeutic interventions for post-refractive surgery dry eye. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of literature published until August 2023 was conducted, focusing on post-refractive surgery dry eye. Eighteen relevant studies were identified through screening and eligibility assessment. A qualitative synthesis of outcomes was performed using narrative and thematic analysis methods. Surgically induced neurotrophic deficiency, stemming from nerve transection, triggers a cascade of events including apoptosis, inflammation, and lacrimal dysfunction, ultimately leading to tear film instability. Risk factors such as female gender, thyroid eye disease, meibomian gland dysfunction, higher ablation depths, and the use of LASIK over surface ablation exacerbate the condition. While conventional treatments like artificial tears provide temporary relief, emerging interventions such as nerve growth factors, matrix metalloproteinase inhibitors, serum eye drops, and specialized contact lenses show promise in promoting nerve regeneration and epithelial healing. Strategies such as customized ablation profiles, smaller optical zones, and nervesparing techniques like small incision lenticule extraction demonstrate potential advantages. A multifaceted therapeutic approach targeting neuroprotection, anti-inflammatory mechanisms, and tear film stabilization is imperative for effectively managing post-refractive surgery dry eye. Future research should focus on evaluating prognostic biomarkers, exploring precision medicine approaches, and investigating neuroprotective adjuvants to further enhance treatment outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

Section: Associations Between Dry Eye and Risk Factorsmentioning

confidence: 99%

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Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Dossari

2024

Cureus

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“…Research also suggests that thyroid dysfunction coinciding with pregnancy may trigger biomechanical changes that may lead to ectasia [2,47]. Anti-inflammatory drugs can inhibit the progression of CE, decreasing the production of inflammatory cytokines, such as MMPs, TNF-a, IL-1b, IL-6, and IL-8, as well as the production of ROS, thereby decreasing corneal stroma damage [4,54]…”

Section: Gendermentioning

confidence: 99%

“…Anti-inflammatory drugs can inhibit the progression of CE, decreasing the production of inflammatory cytokines, such as MMPs, TNF-α, IL-1β, IL-6, and IL-8, as well as the production of ROS, thereby decreasing corneal stroma damage [4,54]. Specifically, Shetty et al identified cyclosporine A, an immunosuppressive steroid-sparing agent capable of inhibiting MMP9, elevated in tear films of KC patients and shows promise at stabilizing the disease [55 ▪▪ ].…”

Section: Treatmentmentioning

confidence: 99%

Ocular surface inflammation and ectatic corneal disorders

Erdinest

Wajnsztajn

London

et al. 2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review Inflammatory mediators are a focus of recent corneal ectasia (CE) research and are a profound, modifiable contributor to CE in general and keratoconus (KC) in particular, opening a path to explore new methods of control. As advanced imaging technology and expanded population screening allow for earlier detection, the possibility of early intervention can profoundly change the prognosis of CE. Recent findings Significant increases in the inflammatory mediators and immune components have been observed in the cornea, tear fluid, and blood of ectasia patients, while inflammation dampeners such as vitamin D and their receptors are reduced. Atopy and allergy have a strong association with KC, known to increase itch factors and stimulate eye rubbing, a risk factor in ectasia pathogenesis. Management of atopy or allergic conditions and topical anti-inflammatories has helped stabilize CE disease. Summary Strategies such as monitoring inflammatory factors and using immune or inflammatory modulators, including managing subclinical inflammation, may be clinically beneficial in stabilizing the disease and improving outcomes. The detected factors are biomarkers, but as yet unproven to be sensitive or specific enough to be considered biomarkers for early detection of CE. The establishment of such biomarkers could improve the therapeutic outcome.

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Effects of Topical 0.05% Cyclosporine A on Dry Eye Symptoms and Parameters Following Small Incision Lenticule Extraction

Zhu,

Li,

Wang

et al. 2024

J Refract Surg

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Purpose: To evaluate the effects of topical 0.05% cyclosporine A on Ocular Surface Disease Index (OSDI) score and ocular surface parameters after small incision lenticule extraction (SMILE) for myopia. Methods: In this study, 151 patients who underwent SMILE were randomized into the control group (71 eyes) and the 0.05% cyclosporine A group (80 eyes). Both groups received standard treatment during the 1 month after SMILE. Over the next 3 months, The control group continued standard therapy (0.3% sodium hyaluronate) and the 0.05% cyclosporine A group received additional 0.05% cyclosporine A. OSDI total and subscale scores, non-invasive tear break-up time (NIBUT), tear lipid layer thickness (LLT), and tear meniscus height (TMH) were assessed preoperatively and postoperatively. Results: Compared to baseline, the OSDI scores significantly increased in both groups ( P < .001). The 0.05% cyclosporine A group exhibited lower OSDI total scores after administering 0.05% cyclosporine A versus the control group ( P = .026). At 1 month of follow-up, NIBUT, LLT, and TMH values significantly decreased in both groups compared to baseline ( P < .05). The 0.05% cyclosporine A group exhibited higher NIBUT, LLT, and TMH versus the control group, returning to preoperative values after 2 months. Overall, the OSDI total score and NIBUT values during follow-up were not significantly different between the two groups; however, the LLT and TMH values were significantly different between the two groups ( P < .001 and .041, respectively) by repeated measures analysis of variance. Conclusions: Topical 0.05% cyclosporine A was effective in relieving subjective dry eye symptoms and maintaining ocular surface stability in the early postoperative period of SMILE. [ J Refract Surg . 2024;40(4):e229–e238.]

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Impact of Topical Cyclosporine-A or Topical Chloroquine on Post-LASIK Ocular Surface Stability – A Randomized Controlled Trial

Cited by 3 publications

References 23 publications

Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Post-refractive Surgery Dry Eye: A Systematic Review Exploring Pathophysiology, Risk Factors, and Novel Management Strategies

Ocular surface inflammation and ectatic corneal disorders

Effects of Topical 0.05% Cyclosporine A on Dry Eye Symptoms and Parameters Following Small Incision Lenticule Extraction

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