Effectiveness of topical ciclosporin A treatment after excision of primary pterygium and limbal conjunctival autograft

Aim: To study the efficacy and safety of topical ciclosporin A (CsA) as an adjunctive therapy after surgical treatment of primary pterygium including excision and limbal conjunctival autograft (LCA) with respect to postoperative pain and complications. Patients and method: A prospective randomized clinical study was conducted in 60 consecutive patients with primary pterygium. Sixty eyes were operated on using the same surgical technique including excision and LCA. Thirty eyes were randomly treated with topical 0.05% CsA for 3 months after the surgery as a supplement to the standard topical therapy. All patients were followed for postoperative pain using the visual analog scale (VAS) for I week after surgery and for complications including recurrences for a period of 1 year. Results: The average VAS was significantly lower in the CsA group (p=0.034). There was only one recurrence (3.4%) in the CsA group (n=28) and five recurrences (17.9%) in the control group (n=29). The other complications were substantial graft scarring (one in the CsA group, three in the control group), Tenon's granuloma (012), and fibrovascular proliferation (1/3). The ratio of the cases with no complications was statistically significantly higher in the CsA group (p=0.017). Conclusion: This study shows that topical CsA therapy after pterygium surgery may reduce postoperative pain and also decreases complications including recurrences.