AAO: Topical Cyclosporine Speeds Recovery After LASIK Surgery


NEW ORLEANS, Nov. 15 -- Topical cyclosporine significantly accelerates corneal nerve regeneration after LASIK surgery when added to standard postoperative therapy, results of a small study reported here suggest.
Action Points
Explain to interested patients that topical cyclosporine appears to improve recovery of corneal sensitivity after LASIK surgery when added to routine care.
Note that the findings were reported at a medical conference and as a published abstract and should be considered preliminary until they appear in a peer-reviewed journal.
Three months after surgery, corneal sensitivity was significantly better (P<0.01) on five predetermined corneal areas when treated with cyclosporine plus standard therapy versus standard therapy alone, Sunil Shah, M.D., of the Birmingham and Midland Eye Institute in Birmingham, England, told attendees at the American Academy of Ophthalmology meeting.
"This is just a small study, but I have to wonder whether, when we come back next year, people will be doing this routinely," said Dr. Shah.
Following LASIK surgery, nerves that are severed during the procedure recover gradually. The time required for regeneration can vary, particularly in patients who are already compromised for other reasons, said Dr. Shah.
To determine whether topical cyclosporine 0.05% could accelerate recovery of corneal sensitivity, investigators treated 19 patients who underwent LASIK surgery. In each patient, one eye received routine care and the other eye was treated with routine care plus cyclosporine.
Using a Cochet-Bonnet esthesiometer, Dr. Shah assessed corneal sensitivity on four untreated areas of the cornea, four peripheral areas on the corneal flap, and one area in the center of the flap.
One month after LASIK surgery none of the nine areas differed between eyes treated with routine care and those treated with cyclosporine. At 90 days none of the areas on the untreated portion of the cornea differed in sensitivity, whether treated with routine care alone or with cyclosporine.
However, four of the five areas on the corneal flap demonstrated about 85% recovery of sensitivity with cyclosporine compared with less than 70% for routine care at 90 days. An area close to the flap hinge was the only one that was not significantly better with cyclosporine, and that area demonstrated a trend toward improved sensitivity with cyclosporine (P=0.06).
"There was no danger from using cyclosporine in these patients," said Dr. Shah. "This might be something we should consider using once we have more data."
Dr. Shah disclosed financial relationships with Bausch & Lomb, Lenstec, OptiVue, Reichert Inc., and Pfizer.Primary source: American Academy of OphthalmologySource reference: Shah S, et al "Cyclosporine accelerates corneal nerve regeneration after LASIK flaps" AAO Meeting 2007; 130.