• Refractive Mgmt/Intervention

    This prospective study found that the prophylactic use of cyclosporine A after PRK or LASIK is not indicated in a young and healthy population, as it did not produce any benefit in terms of final visual acuity, refractive outcomes or contrast sensitivity.

    Subjects were 124 patients who underwent PRK or LASIK and were then randomized to a standard postoperative treatment regimen with or without the addition of topical cyclosporine A 0.05% emulsion twice daily for three months.

    The use of cyclosporine A did not provide a significant benefit in the rate of visual recovery, final UDVA or patient symptoms, nor did it significantly change measured levels of cytokines present in the tear film.

    Reports of photophobia were worse with cyclosporine one day postoperatively but better by three months postoperatively. PRK patients reported significantly more pain by one day postoperatively with cyclosporine than without it. This subjective report may be related to increased stinging with instillation of the acidic cyclosporine drop, although patients were instructed to report their current pain level in the clinic. LASIK patients had no significant difference in symptoms at any time.

    The authors note that this research did not attempt to define the best refractive surgery medication regimen for patients with pre-existing eye disease, such as dry-eye syndrome, as these patients would have been excluded from this study. For patients who obtain relief from chronic dry eye with cyclosporine A drops, it may be appropriate to continue that treatment if refractive surgery is considered.