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Cyclosporine-chondroitin improves dry eye signs, symptoms in ongoing trial
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Preliminary study results show significant improvement in dry eye questionnaire scores, subjective symptoms and corneal staining in patients with using 0.1% cyclosporine in chondroitin sulfate ophthalmic emulsion.
Cynthia Matossian, MD , FACS, ABES , and colleagues enrolled 75 patients older than 18 years with dry eye in this open-label registry study of Klarity-C (Imprimis).
In her presentation at the American Society for Cataract and Refractive Surgery meeting, Matossian said that while topical cyclosporine has been used to treat dry eye for years, some patients continue to struggle with cost, tolerability and lack of efficacy. She and her colleagues conducted this study to evaluate the efficacy and tolerability of a higher dose in a unique formulation.
Three-month results for 33 patients (76% female) with a mean age of 62 years (27 to 80 years old) indicated a mean change in Ocular Surface Disease Index (OSDI) scores from 39.99 pretreatment to 20.58 post-treatment (p <.001) and a mean change in corneal staining grade from 4.11 to 2.35.
This group of patients experienced marked improvements in OSDI score, with more than one-third scoring in the normal range; they experienced a statistically significant reduction in corneal staining; and patients were “happy with the tolerability and cost of medication,” Matossian reported.
She and her colleagues concluded in the study abstract that this treatment resulted in significant improvement in in OSDI scores, subjective symptoms and corneal staining, with a reduction in the irritation typically seen with other topical dry eye therapies. – by Nancy Hemphill, ELS, FAAO
Reference:
Matossian C, et al. Tolerability and efficacy of topical 0.1% cyclosporine in chondroitin sulfate ophthalmic emulsion: An open-label registry study. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 3-7, 2019; San Diego.
Perspective
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Ahmad M. Fahmy, OD, FAAO, Dipl ABO
This study by Dr. Matossian and colleagues successfully represents a clinically practical approach by focusing on the OSDI and corneal staining in a 3-month period as the primary endpoints. In addition to 0.1% cyclosporine and 0.25% chondroitin sulfate, Klarity-C contains 0.25% dextran, 1% glycerol and 0.1% hydroxypropylmethylcellulose. This combination was chosen to provide bioavailability, retention time on the ocular surface and lubrication in a nonpreserved eye drop.
One of the many challenges in treating ocular surface disease (OSD) and dry eye disease is how to come to the best long-term treatment that helps our patients go about their day symptom-free. One-third of all subjects in this study moved into the normal range on the OSDI. This is consistent with my clinical experience with Klarity-C in compliant patients with moderate to severe disease.
The most improved OSDI scores were in the severe OSD range. This is an important data point, as we sometimes struggle to come to the best combination of treatments for our severe OSD patients. The majority of the patients evaluated were female (76%). This is little higher than my average day, but also does seem to be consistent with most of us focusing on treatment of dry eye disease and makes me think more about how many male patients are going untreated or lost to follow-up.
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