Topical cyclosporine for the treatment of ocular surface changes in contact lens wearers

OBJECTIVE: To assess opportunities for the use of cyclosporine emulsion 0.05% for the treatment of dry eye syndrome in long-term contact lens wearers. MATERIAL AND METHODS: A total of 25 long-term contact lens wearers (50 eyes) with signs of dry eye syndrome and corneal epitheliopathy of different degree, unresponsive to conventional artificial tears therapy, were observed. All of them were prescribed cyclosporine emulsion 0.05% twice daily at 12-hour intervals 10 min before inserting contact lenses or after removing. Biomicroscopy with fluorescein eye stain test, determination of the tear film break-up time (Norn's test), optical coherence tomography of tear meniscus (OCT-meniscometry), Jones test, impression cytology, and corneal confocal microscopy (Confoscan-4, "Nidek", Japan) were used to evaluate the treatment effect. RESULTS: The treatment resulted in better contact lens tolerance, significantly increased mean values of tear film break-up time (by 13.2% at 1 month, 62% at 3 months, and 37.3% at 6 months as compared with the baseline) and basal tear secretion (by 29%, 32%, and 82.4% at 1, 3, and 6 months correspondingly). Confocal microscopy revealed restitution of corneal superficial epithelial structure and cell density. Goblet cells were present in impression cytology specimens. CONCLUSION: Topical use of cyclosporine emulsion 0.05% has a positive effect on morphofunctional parameters of ocular surface and promotes basal tear secretion and precorneal tear film stability.