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Topical cyclosporine A 0.5% as a possible new treatment for superior limbic keratoconjunctivitis
Henry D Perry1, Sima Doshi-Carnevale, Eric D Donnenfeld
1Department of Ophthalmology, North Shore University Hospital-Long Island Jewish Medical Center, Great Neck, New York, USA.
Purpose:
To report the early success of the use of topical cyclosporine A 0.5% drops to treat Theodore's superior limbic keratoconjunctivitis (SLK).
Design:
A retrospective noncomparative case series.
Participants:
Five patients diagnosed with SLK.
Intervention:
All five patients were treated with topical cyclosporine A 0.5% drops as primary or adjunctive therapy after treatment failure in some of prednisolone acetate 1% drops and topical silver nitrate 0.5% application. Topical cyclosporine A 0.5% drops were used four times a day in both eyes.
Main Outcome Measures:
Resolution of symptoms (foreign body sensation and irritation) and signs (rose bengal staining, tarsal papillary reaction, and injection).
Results:
All five patients had long-term (6 months to 3 years) improvement of irritation and foreign body sensation, as well as improvement of injection and filamentary keratitis. Aside from burning on instillation, there were no complications related to this therapy.
Conclusions:
Topical cyclosporine A 0.5% is helpful as primary or adjunctive therapy for SLK. It may also be used as a maintenance drug to prevent recurrence. Further study may delineate the specific role and treatment parameters for the use of topical cyclosporine A 0.5% in the treatment of SLK.