Original article
A Comparison of Vitamin A and Cyclosporine A 0.05% Eye Drops for Treatment of Dry Eye Syndrome

https://doi.org/10.1016/j.ajo.2008.08.015Get rights and content

Purpose

To compare the efficacy of vitamin A (retinyl palmitate) and cyclosporine A 0.05% eye drops in treating patients with dry eye disease.

Design

Prospective, randomized, controlled, parallel group study.

Methods

A total of 150 patients with defined dry eye disease participated (50 in each treatment group). In 3 identical clinical trials, patients were treated twice daily with cyclosporine A 0.05%, or four times daily with retinyl palmitate 0.05%, or with neither cyclosporine or retinyl palmitate. Adjunctive treatment with preservative-free artificial tears was undertaken four times daily in all 3 groups. Corneal fluorescein staining results, Schirmer tear test (without anesthesia) results, tear film break-up time (BUT), dry eye symptom score, and impression cytologic analysis results were obtained before treatment and at the first, second, and third months after initiation of treatment.

Results

Both vitamin A eye drops and topical cyclosporine A 0.05% treatments led to significant improvement in blurred vision, tear film BUT, Schirmer I score results, and impression cytologic findings in patients with dry eye syndrome (P < .05) compared to the control group treated with preservative-free artificial tears alone.

Conclusions

Both vitamin A eye drops and topical cyclosporine A 0.05% treatments are effective for the treatment of dry eye disorder.

Section snippets

Methods

Eligible patients were at least 21 years of age and had a diagnosis of dry eye syndrome refractory to conventional management. The inclusion criteria were: Schirmer test (without anesthesia) results of less than 5 mm/5 minutes in at least one eye; low tear film BUT (<5 seconds); mild superficial punctate keratitis, defined as a corneal punctate fluorescein staining score of one or more in either eye (scale, 0 [none] to 3 [severe]); and symptoms of ocular irritation as assessed by an Ocular

Results

The characteristics of the study patients are presented in Table 1. There were no statistically significant differences in age, gender, or pretreatment tear film or ocular surface parameters among the three patient groups. A total of 150 patients were enrolled in equal numbers across the three treatment groups. The first patient was enrolled in July 2006, and the last patient completed the three-month treatment and evaluation in February 2007.

There was no statistically significant difference

Discussion

The vitamin A eye drops used in our study are preservative free and are composed of polysorbate 80 1% and retinyl palmitate 0.05%. Vitamin A is known to regulate the proliferation and differentiation of corneal epithelial cells, preserves conjunctival goblet cells,8 and has been used in the treatment of eye diseases such as dry eye and superior limbic keratoconjunctivitis for some time.12, 18, 19, 20, 21, 22 Tseng demonstrated that topical all-trans retinoic acid ointment was effective in the

Eun Chul Kim, MD, is a Assistant Professor of the Department of Ophthalmology and Visual Science at the College of Medicine, Catholic University of Korea, Seoul, Korea. He completed a residency and a fellowship at the, KangNam St Mary's Hospital, Seoul, Korea. Dr Kim specializes in cornea, cataract, and refractive surgery, and his research interests include keratoplasty and dry eye syndrome.

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  • Cited by (0)

    Eun Chul Kim, MD, is a Assistant Professor of the Department of Ophthalmology and Visual Science at the College of Medicine, Catholic University of Korea, Seoul, Korea. He completed a residency and a fellowship at the, KangNam St Mary's Hospital, Seoul, Korea. Dr Kim specializes in cornea, cataract, and refractive surgery, and his research interests include keratoplasty and dry eye syndrome.

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