Abstract
Objectives A comparative study was carried out between the cyclosporine A 0.05%, the autologous serum, and combined therapy of both in the treatment of moderate to severe dry eye. Background Dry eye disease is a common and often underdiagnosed condition. Patients and methods A prospective interventional case study was carried out on 30 patients attending the ophthalmology outpatient clinic of Menoufia University; these patients were subdivided as follows: group A received topical autologous serum 20% four times daily for 2 months, group B received cyclosporine A emulsion 0.05% twice daily for 2 months, and group C received topical cyclosporine A emulsion 0.05% two times daily and topical autologous serum 20% four times daily for 2 months. The three groups received nonpreserved tears up to five times daily, to be followed 1 month after stoppage of treatment, except for nonpreserved tears (Refresh Plus). All patients were subjected to a full assessment of history, slit-lamp examination, lissamine green staining of the ocular surface, the tear break-up time test, Schirmer's test, and conjunctival impression cytology before treatment, at 1 and 2 months after treatment, and then 1 month after stoppage of treatment. The results obtained were subjected to a statistical analysis. Results In our study, we found that autologous serum eye drops had a more delayed onset of action, but more sustained action; topical cyclosporine A had a rapid onset of action, but regression occurred soon after stoppage of treatment. Both autologous serum and cyclosporine 0.05% had additive effects with a rapid sustained action. Conclusion Combined topical cyclosporine A emulsion 0.05% and autologous serum eye drops 20% are effective in the treatment of dry eye cases through their combined anti-inflammatory and epitheliotropic effects. Therefore, we recommend the use of combined autologous serum 20% and cyclosporine 0.05% in the treatment of severe dry eye.
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