Cyclosporine A After Cataract Surgery Results in Thicker Lipid Layer, Decreased Meiboscore

Eyedropper and human eye.
The drop regime improved dry eye metrics after cataract surgery, the report shows.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of American Society of Cataract and Refractive Surgery (ASCRS), held in Las Vegas from July 23 to 27, 2021. The team at Ophthalmology Advisor will be reporting on a variety of research presented by the cataract and refractive surgery experts at ASCRS. Check back for more from the ASCRS 2021 Meeting.


After cataract surgery, treatment with 0.05% cyclosporine A (CsA) resulted in increased tear breakup time, lipid layer thickness, and improved meibocore, according to a study presented during the American Society of Cataract and Refractive Surgery (ASCRS) annual meeting held July 23-27, 2021, in Las Vegas.

Patients (N=41) presenting with cataract and had normal lid position and were free from ocular comorbidities were recruited for this prospective, randomized, double-masked clinical trial. Patients were randomized in a 1:1 ratio to receive 0.05% CsA (n=21) or 0.5% carboxymethyl cellulose (n=20) for 3 months. Efficacy was assessed using the Ocular Surface Disease Index, meiboscore, and Schirmer’s I test and for tear breakup time and lipid layer thickness.

The study cohort comprised patients aged mean 65.94 (standard deviation [SD], 10.35) years.

During follow-up, the clinicians observed that tear break-up time was significantly improved among the CsA cohort (P =.003). At the study conclusion, patients treated with CsA had lower meiboscore (P =.016), increased lipid layer thickness (P =.040), and higher tear breakup time (P =.043).

Independent predictors of postoperative lipid layer thickness included preoperative lipid layer thickness (R2, 0.710; P <.001) and CsA treatment (R2, 0.263; P =.045).

There was a significant correlation between lipid layer thickness and follow-up duration (R2, 0.738; P <.001) suggesting a longer CsA treatment time may more greatly improve lipid thickness outcomes.

This study was limited by its small sample size. Additional longer-term studies are needed to assess whether sustained CsA treatment more greatly improves clinical outcomes.

These data indicated 0.05% CsA more greatly improved tear breakup time, lipid layer thickness, and meibocore following cataract surgery compared with 0.5% carboxymethyl cellulose. A significant correlation was observed between treatment time and lipid layer thickness, indicating 0.05% CsA treatment may be a viable longer-term therapy.

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Shin J, Kang MSS, Lee J-E. Efficacy of 0.05% cyclosporine a on the lipid layer and meibomian glands after cataract surgery: a randomized, double-masked study. Presented at: 2021 ASCRS Annual Meeting; July 23-27, 2021; Las Vegas, NV. Poster 73230.