Clinical Ophthalmology (Aug 2023)
A Prospective Study of Cyclosporine A 0.1% Combined with Loteprednol 0.2% vs Cyclosporine A 0.05% Alone in the Treatment of Dry Eye
Abstract
John Hovanesian,1 Thomas Chester,2 Robert C Sorenson3 1Harvard Eye Associates, Laguna Hills, CA, USA; 2Cleveland Eye Clinic, Cleveland, OH, USA; 3Inland Eye Specialists, Hemet, CA, USACorrespondence: John Hovanesian, Harvard Eye Associates, 23961 Calle Magdalena, Suite 300, Laguna Hills, CA, 92653, USA, Tel +1 949 951 2020, Email [email protected]: To examine the efficacy and tolerability of a combination of cyclosporine 0.1% and loteprednol 0.2% (CsA–LE; Klarity CL) in comparison to commercially available cyclosporine 0.05% (CsA; Restasis) in improving signs and symptoms of dry eye.Methods: This multicenter, prospective, randomized, controlled, open-label study evaluated 60 patients randomized to a single treatment for 4 weeks and evaluated at day 0, day 14, and day 28. Comparison was made of corneal higher-order aberrations (HOAs), dry-eye symptoms (SPEED score), tear-breakup time (TBUT), corneal staining, and ocular hyperemia, as well as tolerability of each medication with the validated COMTOL instrument.Results: A total of 56 patients completed enrollment. Corneal HOAs improved significantly with CsA–LE, but not CsA alone. Both groups showed significant improvement (with no significant differences between groups) in SPEED scores, corneal staining, TBUT, and conjunctival hyperemia. Tolerability was similar between the drugs, and no significant safety issues were identified.Conclusion: The combination of CsA 0.1%–LE 0.2% provided significant improvement in corneal HOAs, while CsA 0.05% did not. For all other measures of ocular surface improvement, both medications showed similar benefits. Tolerability was comparable between the formulations. When rapid rehabilitation of the ocular surface is needed to reduce aberrations, CsA–LE is an appropriate choice.Keywords: dry eye, higher-order aberrations, loteprednol, cyclosporine
