The effect of topical cyclosporine A treatment on corneal thickness in patients with trachomatous dry eye

Purpose: The purpose of the present study was to evaluate the effect of topical cyclosporine A (CsA) treatment on corneal thickness (CT) in patients with trachomatous dry eye. Methods: Sixty-four patients with trachomatous dry eye with a Schirmer test showing 5 mm or less and a tear film break-up time (TFBUT) of five seconds or less were included. Thirty-two patients were treated with twice daily application of CsA (0.05% ophthalmic emulsion) plus non-preserved artificial tears, while the remaining 32 patients serving as controls received only non-preserved artificial tears. CT was measured using ultrasonic pachymetry at five locations of the central (CCT) and mid-peripheral cornea, at baseline and after one, three and six months of treatment. Results: At the sixth month of treatment, CT measurements were significantly changed in both groups, compared to baseline. In the CsA treatment group, the mean CCT before and after six months of treatment were 517.4 +/- 36.2 and 546.5 +/- 32.4 mu m, respectively (p < 0.001); yielding an average CCT increase of 29.1 +/- 8.0 mu m (5.62 per cent) from baseline. In the control group, corresponding figures were 520.2 +/- 34.2 and 526.0 +/- 35.4 mu m, respectively (p < 0.01), with an average increase of 5.8 +/- 3.1 mu m (1.11 per cent). Conclusions: In the present study, the CsA treatment group exhibited significantly greater increases in CT compared to controls. Such an increase may indicate an improvement in the integrity of the ocular surface and resolution of the underlying inflammation as a consequence of topical CsA treatment.