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First Author: M.Elgharieb EGYPT
Co Author(s): K. Zaky
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To determine the efficacy of topical cyclosporine eye drops (2 %) in resolving allergic symptoms and signs pre and post LASIK in myopic patients.
Ophthalmology department, Faculty of Medicine, Suez Canal University Hospital, Ismailia, Egypt.
This prospective, interventional , randomized, single-center clinical study compromised 48 myopic eyes of 24 allergic patients received topical cyclosporine 2% for 4 weeks and have got free of any symptoms and signs of allergy with success rate of 100%; before being scheduled to undergo bilateral LASIK using a VISX S4 CustomVue laser (AMO). After surgery, all patients were allocated randomly into two groups. Group A (study group): comprised 12 patients (24 eyes) instructed to take standard postoperative LASIK medications and topical cyclosporine 2% started one day post- LASIK and continue for 4 weeks. Group B ( control group): comprised of 12 patients ( 24 eyes) instructed to standard treatment post-LASIK without cyclosporine therapy and continued for 4 weeks as well. Study visits were scheduled: pretreatment (baseline) 4-5 weeks before LASIK and at 1 day, 1 week, 2 weeks and 1, 3, and 6 months after surgery. Efficacy and safety were evaluated by absence of symptoms and signs of allergy, patient satisfaction, uncorrected visual acuity and refraction.
At the 6-month visit, the mean spherical equivalent was closer to Plano in both groups. The visual acuity was significantly better in the cyclosporine-treated eyes compared to the control eyes (P<0.05). No adverse events from cyclosporine were noted. In the study group, there were no symptoms or signs of allergy throughout 6 months follow-up period while there were mild allergic symptoms in 8 eyes ( 4 patients) of the control group in the form of burning sensation, lacrimation, photophobia, foreign body sensation, and one of them (2 eyes) had mild allergic signs as well. The differences between study group and control group were statistically significant (P? 0.05). Patient satisfaction was higher (100%) in the study group than (88 %) in the control group. The difference between study group and control group was statistically significant (P =0.05).
Allergy was considered a relative contraindication for LASIK surgery but this study assumed that the use of topical cyclosporine (2 %) 4 times/ day for 4 weeks before LASIK and another 4 weeks post- LASIK in allergic patients is an effective and safe treatment which may alter this contraindication and benefit a reasonable number of allergic patients from LASIK surgery.