الفهرس 
Dry eye diseaseOnly 14 pages are availabe for public view
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Abstract
This study aims to compare the clinical effectiveness of eyedrops 0.05%
cyclosporine and artificial tear eyedrops for moderate dry eye. It is a prospective
cross-sectional, non-randomized study involved 80 DED patients, they were
classified into two equal groups; group (1) treated by cyclosporine eyedrops and
group (2) treated by artificial tears eyedrops. They were 30 females (75 %) and
10 males (25 %) in group (1) and 27 females (67.5 %) and 13 males (32.5 %) in
group (2). The ages of group (1) ranged from 21 to 74 years with mean ± SD of
53.5 ± 12.22 years and the ages of group (2) was ranged from 22 to 74 years with
mean of 54.9 ± 12.56 years. Both groups were age and sex matched (p >0.05).
The BCVA and IOP showed statistically insignificant difference (P
>0.05) in comparison between the two studied groups.
Comparison of corneal fluorescein staining, Rose Bengal conjunctival
staining and Schirmer’s test between the two groups showed significant increase
in improvement by time (p <0.05) with highly significant change from pretreatment
to post-treatment values in inter group comparison in group 1 (p
<0.001) and significant in group 2 (p <0.05), comparison between change in both
groups showed more significant change (and hence more improvement) in
cyclosporin group (p <0.001).
Comparison of Treat break-up time (TBUT) between the two groups
showed significant increase in improvement by time (p <0.05) with highly
significant change from pre-treatment to post-treatment values in intergroup
comparison in group 1 (p <0.001) and highly significant in group 2 (p = 0.003),
comparison between change in both groups showed more significant change (and
hence more improvement) in cyclosporin group (p <0.001).
Comparison of tear meniscus height (TMH) between the two groups
showed non-significant improvement (p >0.05) with highly significant change
Summary & Conclusion
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from pre-treatment to post-treatment values in intergroup comparison in both
groups (p <0.01), comparison between change in both groups showed significant
change (and hence more improvement) in cyclosporin group (1) than artificial
tears group (2) (p <0.001).
As regard meibomian gland function in both groups; before treatment
meibomian gland function was normal in 7 cases (17.5%) increased to 26 cases
(65%) in cyclosporin group, while it was normal in 5 cases (12.5%) increased to
15 cases (37.5%) with statistically highly significant difference (p <0.001) in both
groups.
In cyclosporin group MGD was mild in 15 cases (37.5%) decreased to
13 cases (32.5%), moderate in 15 cases (37.5%) decreased to only one case
(2.5%) with statistically highly significant (p <0.001), while it was marked in 3
cases (7.5%) who was completely recovered at the end of the follow-up period (3
months) with statistically significant difference (p =0.024). In artificial tears
group; MGD was mild in 17 cases (42.5%) decreased to 12 cases (30%) with
statistically highly significant difference (p =0.001), moderate in 16 cases (40%)
decreased to 12 case (30%) with statistically highly significant (p =0.002), while
it was marked in 2 cases (5%) decreased to only one case (2.5%) at the end of the
follow-up period (3 months) with statistically significant difference (p =0.012).
Comparison of MGD between the two studied groups during the periods
showed improvement of MGD in both groups from pre-treatment to posttreatment
during the study period (3 months). However, cyclosporin group
showed more significant improvement than artificial tears group (p =0.005).
Comparison of lid wiper staining in the two studied groups showed more
significant improvement in cyclosporin than artificial tears after 1, 2 and 3 months
of treatment (p <0.001), however both treatment modalities showed significant
improvement after treatment compared to baseline.
Summary & Conclusion
93
This study showed the tear floaters in cyclosporin group were absent before treatment in 14 cases (35%) increased to 33 cases (82.5%) at the end of the follow-up period (3 months) with statistically highly significant difference (p <0.001). Floaters were mild in 10 cases (25%) decreased to 7 cases (17.5%) with statistically highly significant difference (p = 0.005), moderate in 13 cases (32.5%) disappeared at the end of the follow-up period with statistically highly significant (p <0.001), while it was severe in 3 cases (7.5%) disappeared at the end of the follow-up period (3 months) with statistically highly significant difference (p =0.009). In artificial tears group before treatment floaters were absent in 13 cases (32.5%) increased to 22 cases (55%) at the end of the follow-up period (3 months) with statistically highly significant difference (p <0.001). Floaters were mild in 15 cases (37.5%) without change after 3 months of treatment with statistically non-significant difference (p >0.05), moderate floaters were found in 10 cases (25%) decreased to 3 cases (7.5%) with statistically highly significant (p =0.001), while it was severe in 2 cases (5%) disappeared at the end of the follow-up period (3 months) with statistically significant difference (p =0.021).
Comparison of improvement in tear floaters between the two studied groups during the periods of treatment showed improvement of tear floaters in both groups from pre-treatment to post-treatment during the study period (3 months). However, cyclosporin group showed more significant improvement than artificial tears group (p =0.002).
Summary & Conclusion
94
Conclusion
Cyclosporin 0.05% eyedrops is a well-tolerated, effective and safe for treatment of active ocular surface inflammation of moderate dry eye. These benefits were achieved with a one or two daily instillations, that compared with tear substitutes that require multiple instillations for efficacy, may reduce patient burden and improve quality of life.
Summary & Conclusion
95
Recommendations
Future researches are required on larger samples for more evaluation of cyclosporin as a single treatment or in combination with other treatment modalities such as non-steroidal anti-inflammatory drugs for severe cases of DED.