Effectiveness of Topical Cyclosporine A Treatment After Excision of Primary Pterygium

Purpose: To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA) (Restasis, Allergan Pharmaceutical) eye drops in preventing the recurrence of pterygium after excision of primary pterygium. Material and Method: Forty patients with primary nasal pterygium were involved in the study between June 2008 and May 2009. The patients were divided into two groups: a treatment group of 20 patients and a control group. At the 7th postoperative day and after epithelialization of the wound was complete, topical 0.05% cyclosporine A (Restasis (R), Allergan Pharmaceutical) was applied twice a day to the treatment group. Recurrence was defined when there was a fibrovascular growth >0.5 mm on the cornea. All statistical analyses were performed using NCSS 2007& PASS 2008 Statistical Software (Utah, USA). Results: The pterygium recurred in 2 (10.0%) of 20 eyes in the treatment group and in 8 (40.0%) of 20 eyes in the control group. The difference between the two rates was statistically significant (p=0.028). The control group had 2 (95% Cl: 1.16-3.42) times higher risk of pterygium recurrence compared with the treatment group. In the treatment group, recurrence of pterygium was observed in 2 eyes with a mean recurrence time of 7.50 +/- 0.7 months, and in the control group, recurrence was observed in 8 eyes with a mean recurrence time of 4.25 +/- 1.03 months. The estimated one-year recurrence-free rates for the patients treated with topical CsA and without CsA were 87.5 +/- 8.3% and 60.0 +/- 11.0%, respectively; the recurrence-free time was 11.5 +/- 0.33 months in the treatment group and 8.9 +/- 0.86 months in the control group. A statistically significant difference in recurrence-free probabilities was found for the treatment and control groups (log-rank test: 5.74; p=0.017; p<0.05). Discussion: This study suggests that primary excision of pterygium with postoperative use of 0.05% cyclosporine A is both safe and efficient.