Short-term effects of topical cyclosporine A 0.05% (Restasis) in long-standing prosthetic eye wearers: a pilot study

Abstract

Purpose Long-standing prosthetic eye wearing induces ocular surface inflammation. We investigated the short-term effects of topical cyclosporine A 0.05% (Restasis) in patients with ocular discomfort resulting from long-standing prosthetic eye wearing. Methods This was a prospective, interventional case series. Patients who were unilateral prosthetic eye wearers over a period of 5 years were enrolled at a single institution from March to July 2013. The subjects were instructed to instill topical cyclosporine A 0.05% twice per day. Measurements were made pre-treatment and after 1 and 3 months of treatment. Outcome measures were the ocular symptom score, the lid margin abnormality score, the Schirmer test, and the tear meniscus amount, using Fourier-domain optical coherence tomography. Results In total, 20 consecutive patients (mean age: 60.1 years, 8 males, 12 females) were included. Ocular symptoms were improved after treatment for 1 month in all patients (ocular symptom score pre-treatment 76.83 vs 46.75 after treatment; Po0.001). There was no statistically significant difference in lid margin abnormality score or tear meniscus amount. The Schirmer test results were improved after treatment for 3 months (pre-and after treatment, 6.70 vs 11.40; Po0.001). Conclusions Topical cyclosporine A 0.05% showed a satisfactory effect in long-standing prosthetic eye wearers. Ocular symptoms were markedly relieved in all subjects after treatment for 1 month.

Persistent socket pain postenucleation and post evisceration: a systematic review

“…Discomfort can be interpreted in multiple ways: it encompasses discharge; pain; ocular fatigue; foreign body sensation; dryness; sticky sensation; tearing; itching; burning; heavy sensation; excessive blinking and uncomfortability in windy or very dry conditions (Han et al 2014). Discomfort can be interpreted in multiple ways: it encompasses discharge; pain; ocular fatigue; foreign body sensation; dryness; sticky sensation; tearing; itching; burning; heavy sensation; excessive blinking and uncomfortability in windy or very dry conditions (Han et al 2014).…”

“…It was observed that articles frequently reported 'discomfort' when describing patient symptoms. Discomfort can be interpreted in multiple ways: it encompasses discharge; pain; ocular fatigue; foreign body sensation; dryness; sticky sensation; tearing; itching; burning; heavy sensation; excessive blinking and uncomfortability in windy or very dry conditions (Han et al 2014). We excluded articles that reported patients having discomfort.…”

“…A postulated mechanism is that continuous rubbing and wriction between the prosthesis and the socket may result in mechanical trauma to Meibomian glands and gland dysfunction, with subsequent alteration of the tearfilm (Han et al 2014). A postulated mechanism is that continuous rubbing and wriction between the prosthesis and the socket may result in mechanical trauma to Meibomian glands and gland dysfunction, with subsequent alteration of the tearfilm (Han et al 2014).…”

“…related cause of pain as tear fluids are probably reduced in all anophthalmic patients (Allen et al 1980). Han et al 2014 studied the use of cyclosporine A (0.05%, one drop twice per day for 3 months), an anti-inflammatory drug, on symptoms in 20 anophthalmic patients. Han et al 2014 studied the use of cyclosporine A (0.05%, one drop twice per day for 3 months), an anti-inflammatory drug, on symptoms in 20 anophthalmic patients.…”

“…Treatment with lubricants, antiinflammatory medicines and antibiotics (Shah-Desai et al 2000;Jordan et al 2003Jordan et al , 2004b) may be of partial benefit. Comparative double-blind studies with a long-term follow-up are needed to investigate lubricants and anti-inflammatory medicines (Han et al 2014). We did not include this study because it was unclear if patients experienced persistent pain; however, it is worth mentioning that the ocular symptoms 'pain' and 'tear secretion' improved significantly after 3 months of cyclosporine A usage.…”