Topical Cyclosporine-A for Management of Epiphora in Eyes with Acquired Punctal Stenosis ()
ABSTRACT
Background: Cyclosporine A (CsA) is an inhibitor of calcineurin that prevents T-cell production of inflammatory cytokines and disrupts the immune-mediated inflammatory response that plays a crucial mechanism in punctal stenosis. Purpose: To evaluate the clinical outcomes and tolerances of CsA in treating epiphora in eyes with punctal stenosis. Study Design: Prospective study. Methods: The study included patients who presented with symptomatic epiphora associated with lower punctal stenosis during the period between July 2019 and December 2020. Patients were treated with topical 0.05% CsA on twice daily dose with topical preservative-free artificial tears Q.I. D. Patients were followed up monthly for at least 3 months by Munk epiphora grading, Fluorescein dye disappearance test (FDT) and evaluation of the patient satisfaction. Results: A total of 26 patients with 47 eyes were included in the study with a mean age of 55.1 ± 10.24 years. All the eyes had grade 0 lower punctal stenosis with grade 4 on Munk grading and grade 3 in FDT. There was a statistically significant difference in the Munk grading and FDT along the follow-up period compared to the baseline values (p < 0.001). Patient’s satisfaction was complete in 7 (26.9%) patients in the first month and 19 (73%) by the 3rd month. None of the patients encountered any complications during treatment. Conclusion: CsA can control the inflammation of the conjunctival sac and restore the integrity of the ocular surface with subsequent symptomatic relief of the epiphora in eyes with punctal stenosis.
Share and Cite:
Nassief, M. , Abdelhameed, A. and Hagras, S. (2022) Topical Cyclosporine-A for Management of Epiphora in Eyes with Acquired Punctal Stenosis.
Open Journal of Ophthalmology,
12, 209-217. doi:
10.4236/ojoph.2022.123020.
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