Abstract
Abstract: :
Purpose: To assess the efficacy of topical cyclosporine .05% (Restasis®) versus Tobradex® in patients with chronic posterior blepharitis. Methods: Prospective, randomized study of 30 patients with posterior blepharitis. Patients were randomized to twice a day treatment with either cyclosporine or Tobradex®. Visual acuity, slit–lamp appearance, and intraocular pressure were evaluated every 2 weeks for 3 months. In addition, Schirmer’s tests, noninvasive fluorescein break up time, and tear lysozyme were also performed. Measures of eyelid health including lid erythema, meimobian gland metaplasia, meibomian gland expression, and meimobian gland secretion quality were also evaluated. Patients were queried regarding symptoms of itching, burning, tearing, and blurred vision. Results: Posterior blepharitis improved significantly with both cyclosporine treatment and Tobradex®. Cyclosporine provided greater improvements in Schirmer’s scores (P<.001) and tear break–up time (P=.018) than Tobradex® after 12 weeks of treatment. Eyelid health also improved in both groups, but the mean improvement in gland secretion quality was significantly greater with cyclosporine than with Tobradex® (P=.015). Moreover, a higher percentage of patients in the cyclosporine treatment group had improvements in blurred vision, burning, and itching and more cyclosporine treated patients experienced resolution of lid margin metaplasia and lid telangiectasia. Conclusions: The findings in this prospective study suggest that posterior blepharitis can be more effectively treated with cyclosporine than with Tobradex®. These findings should be further evaluated in large–scale, controlled clinical trials.
Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled • inflammation • cornea: tears/tear film/dry eye