Effectiveness and Optical Quality of Topical 3.0% Diquafosol versus 0.05% Cyclosporine A in Dry Eye Patients following Cataract Surgery

Purpose.To evaluate the effectiveness and optical quality of 3.0% topical diquafosol versus 0.05% cyclosporine A in dry eye patients following cataract surgery.Methods.In total, 40 eyes of 40 patients newly diagnosed with dry eye syndrome 1 week after cataract surgery were randomized to receive either 3.0% diquafosol ophthalmic solution six times daily or 0.05% cyclosporine A twice daily for 3 months. Outcome measures were tear film break-up time (TBUT), results on Schirmer 1 test, ocular surface staining score, the ocular surface disease index (OSDI) score, and higher-order aberrations (HOAs). Measurements were taken at baseline and at 1, 2, and 3 months.Results.In the diquafosol group, TBUT showed higher outcomes than the cyclosporine A group at 1 and 3 months. Both groups showed increased scores on Schirmer 1 test. The ocular surface staining score decreased in all periods in both groups. Vertical coma and total HOAs decreased more in the cyclosporine A group than in the diquafosol group at 3 months.Conclusion.Both 3.0% diquafosol and 0.05% cyclosporine A were effective in treating dry eye after cataract surgery. Diquafosol was more effective in increasing the tear secretion, but cyclosporine A was more effective in improving optical aberrations.

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Effect of Oral Choline Alfoscerate on Patients with Keratoconjunctivitis Sicca

Nutrients ◽

10.3390/nu12051526 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1526

Author(s):

Jin Ju Choi ◽

Jin Sun Hwang ◽

Young Joo Shin

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Keratoconjunctivitis Sicca ◽

T Test ◽

Ocular Surface Disease Index ◽

Staining Score ◽

Symptom Frequency ◽

Surface Staining ◽

Visual Analog Pain Score ◽

Paired T Test

Keratoconjunctivitis sicca (KCS) or dry eye is a disease characterized by ocular surface symptoms. This study aimed to investigate the effectiveness of oral choline alfoscerate (CA) administration as a treatment for KCS. The medical records of dry eye patients who were refractory to topical eyedrops and then took oral CA were reviewed. Results of tear break-up time (TBUT), fluorescein ocular surface staining score (FSS), and tear secretion by the Schirmer test (STT) were analyzed. The results of the ocular surface disease index (OSDI), visual analog pain score (VAS), reporting of the severity and frequency of symptoms, and the modified Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire were also analyzed. The records of 47 patients were analyzed for this study. The mean age was 62.8 ± 9.3 years, and the patients included 9 males and 38 females. TBUT, OSDI, and VAS significantly improved after CA administration compared to before (p < 0.05, paired t-test). After CA administration, symptom frequency and impact on life improved (p < 0.05, paired t-test). No significant change in photophobia or FSS was identified. In conclusion, oral CA administration was effective in improving tear stability and alleviating symptoms of KCS.

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A Comparison of Symptoms and Signs in Patients with Inflammatory Dry Eye Disease using two Commercially Available Treatment Formulations of Cyclosporine A

10.21203/rs.3.rs-716429/v1 ◽

2021 ◽

Author(s):

Jonatan Olafsson ◽

Snorri Olafsson ◽

Hugo Lewi Hammer ◽

Behzod Tashbayev ◽

Øygunn A. Utheim ◽

...

Keyword(s):

Dry Eye ◽

Cyclosporine A ◽

Ocular Surface ◽

Ocular Surface Disease Index ◽

Treatment Groups ◽

Surface Staining ◽

Work Up ◽

Symptoms And Signs ◽

Significant Superiority ◽

Ocular Surface Inflammation

Abstract Purpose: Dry eye (DED) is a multifactorial disease of the ocular surface in which ocular surface inflammation and damage play etiological roles. In the present study, we compared symptoms and signs in patients with DED treated with 0.1% Cyclosporine A (CsA) cationic emulsion (Ikervis, Santen) and 0.05% CsA anionic emulsion (Restasis, Allergan).Methods: Single-center, retrospective, 202 consecutive DED patients were treated with 0.1% CsA cationic emulsion (Ikervis, n=101) or 0.05% CsA anionic emulsion (Restasis, n=101) over six months. Ophthalmological work-up included Ocular Surface Disease Index (OSDI) questionnaire, fluorescein break-up time (FBUT), fluorescein ocular surface staining (OSS), Schirmer’s test, meibum expressibility (ME), and meibum quality (MQ). Results: In both treatment groups, subgroup analysis revealed a significant improvement of OSDI only in patients with severe symptoms at baseline (OSDI 33-100). Ikervis-treated patients with OSDI <23 at baseline had a significant increase in symptoms. OSS and FBUT improved significantly in most subgroups irrespective of Ikervis or Restasis being used. Regression analysis revealed a significant superiority to Restasis with regard to FBUT improvement and superiority to Ikervis in regards ME improvement. Conclusions: We conclude that there is seemingly no substantial difference in efficacy between the two drugs. The strength of Restasis is increased efficacy at improving FBUT and of Ikervis improving ME.

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Dry Eye Syndrome-Related Quality of Life in Glaucoma Patients

European Journal of Ophthalmology ◽

10.1177/112067210901900409 ◽

2009 ◽

Vol 19 (4) ◽

pp. 572-579 ◽

Cited By ~ 78

Author(s):

Gemma Caterina Maria Rossi ◽

Carmine Tinelli ◽

Gian Maria Pasinetti ◽

Giovanni Milano ◽

Paolo Emilio Bianchi

Keyword(s):

Quality Of Life ◽

Dry Eye ◽

Ocular Surface ◽

Cross Sectional Study ◽

Dry Eye Syndrome ◽

Control Group ◽

Ocular Surface Disease Index ◽

Symptom Scale ◽

Cross Sectional

Purpose To verify the presence of dry eye syndrome (DES) in treated patients with glaucoma and to analyze DES's impact on the patients' quality of life (QOL) versus the control group. Methods In this observational cross-sectional study, 61 patients were enrolled at a clinical practice. Patients were divided into three groups by number of glaucoma drops instilled per day (G1=1 drop/day, G2=2 drops/day, G3=3 drops/day). A control group of 20 subjects was also selected (G0). All subjects were submitted to a complete ocular examination (including tear function and ocular surface status) and completed the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ), Glaucoma Symptom Scale (GSS) questionnaire, and Ocular Surface Disease Index (OSDI). DES was defined as presence of punctate keratitis and decreased break-up time. Statistical analysis was performed applying the Kruskal-Wallis analysis of variance and Mann-Whitney U tests (to compare median values between groups) as well as the χ2 and Fisher test (to verify significant differences). Results A total of 40% of G3 and 39% of G2 patients presented DES versus 11% of G1 and 5% of G0 (p=0.01). QOL was significantly influenced and altered (NEI-VFQ 25 total mean and GSS total mean and symptoms average: p=0.0085, p=0.006, and p=0.03, respectively). OSDI pointed out differences by group: 26% of G2 and 15% of G3 presented moderate OSDI and 15% of G3 and 8.7% of G2 severe OSDI (p>0.05). Conclusions Patients with topically treated glaucoma present DES more often than a similar control group (p=0.01). The presence of DES negatively influences the patient's QOL. The patients with glaucoma's ocular surface status should be evaluated regularly to ensure the timely detection and treatment of pathologic signs on the ocular surface.

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Comparative Study of Dry Eye Indices Following Cataract Surgery

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i1.29313 ◽

2021 ◽

Vol 13 (1) ◽

pp. 104-111

Author(s):

Bipin Bista ◽

Padam Raj Bista ◽

Sharad Gupta ◽

Raghunandan Byanju ◽

Simanta Khadka ◽

...

Keyword(s):

Comparative Study ◽

Cataract Surgery ◽

Dry Eye ◽

Ocular Surface Disease Index ◽

Small Incision Cataract Surgery ◽

Subjective Analysis ◽

Small Incision ◽

Surgery Group ◽

Surface Staining ◽

Breakup Time

Background: This study aims to assess dry eye indices following cataract surgery. Materials and Methods: A single center descriptive and comparative study was performed. A total of 100 eyes of 100 cases fulfilling the inclusion criteria from 1st June 2017 to 30th May 2018 were enrolled. Out of 100 eyes, 50 eyes each went through manual small incision cataract surgery (MSICS) and phacoemulsification respectively. For objective analysis : schirmer 1 test(ST-I), tear breakup Time(TBUT) along with lissamine Green Surface Staining(LGSS) was performed on pre-operative day, 1st, 4th and 12th week respectively. Ocular Surface Disease Index (OSDI) was done for subjective analysis on pre-operative day and at 12th week. Results: The mean age of the patient was 53.66 ± 7.839 years with 34 (68%) being female in a small incision cataract surgery group. In the phacoemulsification group, mean age was 54.72 ± 7.985 years and 32 (64%) were female. On analyzing the objective dry eye indices: ST-I,TBUT and LGSS at 12thweek was 18.80 ± 7.393 mm, 11.30 ± 5.456 seconds and 1.62 ± 1.193 in Small incision cataract surgery group and 27.10 ± 6.326 mm, 16.60 ± 4.699 seconds and 0.38 ± 0.602 in Phacoemulsification group respectively which was statistically significant. (p< 0.001). Conclusion: Regardless of the type of cataract surgery, dry eye disease is unavoidable affecting both tear quality and quantity postoperatively. In our study, phacoemulsification had lesser effect in dry eye indices than small incision cataract surgery.

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A Randomized Study of the Efficacy and Safety of 0.1% Cyclosporine a Cationic Emulsion in Treatment of Moderate to Severe Dry Eye

European Journal of Ophthalmology ◽

10.5301/ejo.5000952 ◽

2017 ◽

Vol 27 (5) ◽

pp. 520-530 ◽

Cited By ~ 25

Author(s):

Christophe Baudouin ◽

Francisco C. Figueiredo ◽

Elisabeth M. Messmer ◽

Dahlia Ismail ◽

Mourad Amrane ◽

...

Keyword(s):

Dry Eye ◽

Cyclosporine A ◽

Ocular Surface ◽

Severe Disease ◽

Randomized Study ◽

Treatment Compliance ◽

Controlled Study ◽

Efficacy And Safety ◽

Ocular Surface Disease Index ◽

Ocular Discomfort

Purpose The SICCANOVE study aimed to compare the efficacy and safety of 0.1% cyclosporine A cationic emulsion (CsA CE) versus vehicle in patients with moderate to severe dry eye disease (DED). Methods In this multicenter, double-masked, parallel-group, controlled study, patients were randomized (1:1) to receive CsA CE (Ikervis®) or vehicle for 6 months. The co-primary efficacy endpoints at month 6 were mean change from baseline in corneal fluorescein staining (CFS; modified Oxford scale) and in global ocular discomfort (visual analogue scale [VAS]). Results The mean change in CFS from baseline to month 6 (CsA CE: n = 241; vehicle: n = 248) was significantly greater with CsA CE than with vehicle (-1.05 ± 0.98 and -0.82 ± 0.94, respectively; p = 0.009). Ocular discomfort improved similarly in both groups; however, the percentage of patients with ≥25% improvement in VAS was significantly higher with CsA CE (50.2%) than with vehicle (41.9%; p = 0.048). In a post hoc analysis of patients with severe ocular surface damage (CFS score 4) at baseline (CsA CE: n = 43; vehicle: n = 42), the percentage of patients with improvements of ≥2 grades in CFS score and ≥30% in Ocular Surface Disease Index score was significantly greater with CsA CE (p = 0.003). Treatment compliance and ocular tolerability were satisfactory and as expected for CsA use. Conclusion Cyclosporine A CE was well-tolerated and effectively improved signs and symptoms in patients with moderate to severe DED over 6 months, especially in patients with severe disease, who are at risk of irreversible corneal damage.

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A randomised, prospective study of the effects of 3% diquafosol on ocular surface following cataract surgery

Scientific Reports ◽

10.1038/s41598-021-88589-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sangyoon Kim ◽

Jonghoon Shin ◽

Ji Eun Lee

Keyword(s):

Multivariate Analysis ◽

Cataract Surgery ◽

Ocular Surface ◽

Test Score ◽

Surgical Techniques ◽

Sodium Hyaluronate ◽

Ophthalmic Solution ◽

Disease Index ◽

Lipid Layer ◽

Ocular Surface Disease Index

AbstractThere is still no established therapeutic solution for postoperative Dry Eye Syndrome (DES) after cataract surgery, in spite of progress in surgical techniques. Diquafosol tetrasodium (DQS), a recently developed ophthalmic solution, has been reported to be effective in DES, but no study evaluated post-cataract surgery lipid layer thickness (LLT) changes in healthy patients who used DQS postoperatively. We randomly divided participants into two groups; the DQS group was treated six times daily with DQS after cataract surgery, and the sodium hyaluronate (HA) group was treated with HA in the same way. Throughout study period, the DQS group showed significantly higher tear break up time (TBUT) and LLT than HA group. In multivariate analysis, better preoperative TBUT, Schirmer’s I test score, ocular surface disease index (OSDI) score, and LLT were significantly associated with improved postoperative outcomes in each parameter. Also, the postoperative use of DQS served as an independent parameter of better TBUT, OSDI score, and LLT in postoperative 15 weeks. Treatment with 3% DQS following cataract surgery showed more improvement in TBUT and LLT, compared with 0.1% HA. Improving TBUT and LLT preoperatively and using 3% DQS postoperatively, could be a reliable choice for managing DES after cataract surgery.Trial Registration: ISRCTN registry with ISRCTN 18755487.

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Topical Cyclosporine in Treatment of Post-LASIK Symptomatic Dry Eye

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i4.1078 ◽

2020 ◽

Vol 36 (4) ◽

Author(s):

Muhammad Saeed Iqbal ◽

Kanwal Latif

Keyword(s):

Dry Eye ◽

Cyclosporine A ◽

Ocular Surface ◽

Case Series ◽

Tear Film ◽

Disease Index ◽

Ocular Surface Disease ◽

P Value ◽

Statistical Interpretation ◽

Ocular Surface Disease Index

Purpose: To determine the role of 0.05% topical cyclosporine A (CsA) in treatment of symptomatic dry eye after LASIK (Laser-Assisted in Situ Keratomileusis). Study Design: Interventional Case Series. Place and Duration of Study: Ophthalmology Department, Sir Syed Hospital, Karachi, from July 2018 to Dec. 2019. Methods: Seventy-five patients who underwent LASIK for myopic refractive error and presented with symptomatic dry eye and showed no response to artificial tears therapy after 1 month of LASIK were selected. The patient had ablation zone diameter of 6mm and flap diameter was 8.5mm to 9mm. Cyclisporine A 0.05% ophthalmic preparation was added to treatment regimen and response was observed at 1, 3 and 6 months. OSDI (Ocular Surface Disease Index) scores, Tear film break up time (TBUT), Schirmer's test (ST) values and Best Corrected Visual Acuity (BCVA) were recorded to analyze the treatment response at each visit. The statistical interpretation was done by using SPSS version 21. To interpret the correlation between pre-treatment and 6 month post treatment, Paired sample T test was applied with 95% Confidence Interval; CI and p-value of ≤ 0.05. Results: The mean post-LASIK OSDI score of enrolled patients was 54.25 ± 10.81. After 6 months of treatment mean OSDI score was improved to 21.05 ± 5.13 (p < 0.001). Post-LASIK mean ST value was 5.2 ± 1.2 mm and mean TBUT value was 5.6 ± 1.3 seconds, which changed to 9.8 ± 1.0 mm and 8.9 ± 1.1 seconds respectively. BCVA improved from Log MAR 0.14 ± 0.09 to 0.01 ± 0.03 (p < 0.001). Conclusion: Topical CsA 0.05% was effective in alleviating the symptoms of post-LASIK dry eye. Key Words: LASIK, Dry eye, Ocular Surface Disease Index Score, Cyclosporine A.

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Hyaluronic Acid/Trehalose Ophthalmic Solution in Reducing Post-Cataract Surgery Dry Eye Signs and Symptoms: A Prospective, Interventional, Randomized, Open-Label Study

Journal of Clinical Medicine ◽

10.3390/jcm10204699 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4699

Author(s):

Rita Mencucci ◽

Eleonora Favuzza ◽

Giulia Decandia ◽

Michela Cennamo ◽

Fabrizio Giansanti

Keyword(s):

Hyaluronic Acid ◽

Cataract Surgery ◽

Dry Eye ◽

Ophthalmic Solution ◽

Signs And Symptoms ◽

Ocular Surface Disease Index ◽

Open Label ◽

Open Label Study ◽

Group A ◽

Group B

The purpose of this prospective study was to evaluate the efficacy of the perioperative use of a hyaluronic acid (HA) and trehalose ophthalmic solution (Thealoz® Duo) in reducing post-cataract surgery dry eye signs and symptoms in patients with mild/moderate dry eye disease (DED). One hundred and twenty patients, scheduled for unilateral cataract surgery, were randomized into three groups: (1) group A: HA/trehalose three times/day in the preoperative week and for 5 postoperative weeks; (2) group B: HA/trehalose for only 5 postoperative weeks; (3) group C: no artificial tears. In groups A and B, OSDI (Ocular Surface Disease Index) questionnaire scores were significantly lower than group C at all the postoperative visits; in group A they were significantly lower than group B on the day of surgery, with similar results in the first and fifth weeks after surgery. In groups A and B, break-up time (BUT) was significantly higher than group C during the postoperative period (p ≤ 0.001). In comparison to the preoperative values, BUT in group A remained stable 7 days after surgery; however, in groups B and C, it significantly decreased. In conclusion, the HA/trehalose ophthalmic solution effectively reduced post-cataract surgery DED signs and symptoms in patients with mild/moderate DED, particularly if also administered in the preoperative period.

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Characteristics of dry eye patients with thick tear film lipid layers evaluated by a LipiView II interferometer

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-020-05044-5 ◽

2021 ◽

Author(s):

Yunjin Lee ◽

Joon Young Hyon ◽

Hyun Sun Jeon

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Sensitivity Analyses ◽

Lipid Layer ◽

Ocular Surface Disease Index ◽

Surface Staining ◽

Physiologic Condition ◽

Cautious Interpretation ◽

Lipid Layers

Abstract Purpose To investigate the characteristics of eyes with dry eye disease (DED) whose lipid layer thickness (LLT) measured 100 nm on a LipiView II interferometer and compare the DED parameters of them to those with LLT below 100 nm. Methods A total of 201 eyes of 102 enrolled DED patients (mean age 56.4 ± 11.8 years) were classified into 3 groups according to their average LLT; < 60 nm as thin-LLT (n = 49), 60–99 nm as normal-LLT (n = 77), and 100 nm as thick-LLT (n = 75). LLT, meiboscore, Schirmer I test, tear film break-up time (TBUT), ocular surface staining (OSS), and ocular surface disease index (OSDI) were assessed. Results The OSS and TBUT were significantly worse in the thick-LLT group than in the normal-LLT group (p = 0.020, and p = 0.028, respectively). The OSDI was significantly higher in the thick-LLT group than in the thin-LLT group (p = 0.006). However, the meiboscore was not different among the three groups (p = 0.33). Age, OSS, and OSDI showed a positive correlation with LLT (r = 0.16, p = 0.023; r = 0.213, p = 0.003; and r = 0.338, p = 0.001, respectively). In sensitivity analyses, eyes with corneal erosions had a significantly higher average LLT (p = 0.015), higher OSDI (p = 0.009), shorter TBUT (p < 0.001), and shorter Schirmer I value (p = 0.024) than those with clear corneas. Conclusion The average LLT of eyes with corneal erosions was thicker than those without erosions, suggesting that the LLT of 100 nm in the eyes with corneal erosions should not be regarded as a stable physiologic condition. Cautious interpretation of LLT along with other dry eye parameters is required.

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