Local cyclosporin A therapy in Thygeson superficial punctate keratitis--a pilot study

Abstract

It was the purpose of this prospective study to evaluate the effect of topical Ciclosporin 2% on epithelial and subepithelial opacities in Thygeson's superficial punctate keratitis. We administered Ciclosporin A 2% eye drops to 31 eyes of 17 patients with Thygeson's superficial punctate keratitis. The initial dose was 3 drops daily during the first month. It was reduced according to the following scheme: 2 drops in the second month, 1 drop in the third month, 1 drop every second day in the fourth to sixth months. Thereafter therapy was stopped. The opacities were suppressed completely in 21/31 eyes mostly after 4 weeks of therapy and incompletely in 8/31 eyes. Of the 21 eyes with complete suppression, 6/21 showed recurrent opacities when therapy was stopped after six months. 7/21 eyes had no recurrences after cessation of therapy. Follow-up of 8 eyes is currently less than 6 months and these eyes still receive Ciclosporin A 2% eye drops. All patients complained of a slight burning caused by the drops. In the majority of patients with Thygeson's superficial punctate keratitis topical Ciclosporin A 2% suppresses epithelial and subepithelial opacities as long as this non-steroid therapy is administered at a low dose. In a considerable percentage therapy seems to be curative.