Cyclosporine Drops Ease Discomfort After Cataract Surgery

TOPLINE:

Patients older than 75 years who undergo cataract surgery report more frequent failure of the ocular surface after the procedure than those younger than 65 years; however, the prophylactic administration of cyclosporine A eye drops can reduce ocular discomfort associated with the surgery.

METHODOLOGY:

• Researchers evaluated 100 adults aged 18-65 years (n = 25) or older than 75 years (n = 75) between February and October 2021 who had cataracts and were scheduled for phacoemulsification surgery with implantation of an intraocular lens.
• All patients younger than 65 years and 25 of those older than 75 years underwent cataract surgery only; the remaining 50 patients older than 75 years received eye drops containing a cationic emulsion of 0.1% cyclosporine A (n = 25) or lubricating drops (n = 25) 30 days before the procedure.
• Patients were required to attend follow-up visits on days 7, 15, 45, and 90 after surgery.
• The primary outcome was postoperative failure of the ocular surface in patients older than 75 years vs those younger than 65 years.
• The secondary outcomes were postoperative inflammation and failure of the ocular surface in patients older than 75 years who received cyclosporine drops and those who did not receive prophylactic drops before surgery.

TAKEAWAY:

• Patients older than 75 years reported worsened conjunctival inflammation, meibomian gland dysfunction, and tear film instability after cataract surgery than those younger than 65 years at all postoperative visits (P
• Among patients older than 75 years, those who received cyclosporine A eye drops 30 days before surgery experienced less severe conjunctival hyperemia and a greater improvement in tear instability and meibomian gland dysfunction than those who did not receive drops (P
• The administration of cyclosporine A eye drops also was associated with a downregulation in the levels of inflammatory biomarkers such as human leukocyte antigen DR, intercellular adhesion molecule 1, and interleukin 6, according to the researchers.

IN PRACTICE:

“Since cataract formation is an age-related disease, surgical intervention is primarily performed in older patients who are at greater risk of ocular surface postoperative failure,” the authors wrote. “Most patients (particularly older or frail individuals) would therefore benefit from a short-term preoperative regimen that reduces ocular surface inflammation such as topical cyclosporine A eye drops.”

SOURCE:

Antonio Di Zazzo, MD, of the Ophthalmology Complex Operative Unit at Campus Bio-Medico Foundation, in Rome, Italy, led the study, which was published online on May 17, 2024, in Cornea.

LIMITATIONS:

There were no limitations mentioned in this study.

DISCLOSURES:

This study was supported by a grant from Santen SPA and partly by the Italian Ministry of Health. The authors declared no conflicts of interest.