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The Role of Restasis in Faster Visual Acuity Recovery After Refractive Surgery

University of California San Diego, Shiley Eye Center, La Jolla, CA

Commercial Relationships: R. Ursea, None; M. Lovaton, None; M. Ehrenhaus, None; B. Tan, None; C. Heichel, None; D.J. Schanzlin, None.

Support: None.

Abstract

Purpose: Restasis (cyclosporine 0.05%, Allergan), is thought to improve tear production and combat post–LASIK inflammation. Our aim in this study was to compare refractive outcome and complications following LASIK in a group of 54 patients treated with Restasis (Cyclosporine 0.03%) in addition to the usual topical steroids and antibiotic drops versus a control group of 46 subjects not receiving Restasis.

Methods: Retrospective analysis of one hundred patients underwent Lasik correction for different refractive errors. Patients underwent a complete ophthalmic examination prior to the procedure for evidence of dry eyes. All patients in this series were initially evaluated with best corrected visual acuity, complete slit lamp biomicroscopy and dilated fundus examination, Schirmer test, tear break–up time, fluorescein and rose Bengal staining. They answered a questionnaire regarding dry eyes complains before and 6 weeks after the refractive surgery. Restasis was added to the postoperatory drops regimen in 54 patients. Results were compared with patients that did not receive Restasis.

Results: Our 100 patients consisted of 54 females and 46 males, with an age ranging from 22 to 69 years. Fifty–four patients were treated with Restasis. At the onset of Restasis therapy 63% patients had complains of dry eyes. Almost half (25 patients, 46.3%) achieved 20/15 vision at one week after surgery, 21 patients (38.9%) had 20/20 vision and 8 patients (14.8%) had worse than 20/25. In the group of 46 patients not receiving Restasis, the majority (26 patients, 56.5%) did not improve to better than 20/25 at 1 week postop. During the course of therapy none of the patients reported adverse effects to the use of Restasis. Patients using Restasis were significantly more likely than patients who did not use Restasis to have 20/15 vision (P=.017). Patients who did not use Restasis were significantly more likely than patients who did use Restasis to have a visual outcome worse than 20/20 (P<.001).

Conclusions: Restasis might be effective in fast visual recovery after refractive surgery, besides improving the dry eyes syndrome. Future studies are required to determine long–term efficacy of Restasis in maintaining a good visual acuity and in treating dry eyes and if higher Restasis doses are required and well–tolerated.

Key Words: refractive surgery • pharmacology • visual acuity

© 2005, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any part of this abstract, contact the ARVO Office at arvo{at}arvo.org.