Qian Wenzhe, Wu Yue, Liu Xin, Liu Yuying, Li Min, Zhao Ting, Chen Na, Ke Bilian
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.
National Clinical Research Center for Eye Diseases, Shanghai, China.
J Ophthalmic Inflamm Infect. 2025 Apr 3;15(1):36. doi: 10.1186/s12348-025-00462-0.
Corneal refractive surgeries offer rapid vision correction, while dry eye disease remains a common postoperative complication that significantly impacts patients' quality of life. The etiology of postoperative dry eye is multifactorial. Cyclosporine A (CsA) has been employed in the treatment of dry eye due to its ability to suppress T cell-mediated immune responses and reduce inflammation. The present study was designed to assess the early effect of 0.05% cyclosporine A (CsA) eye drops on tear film stability, ocular surface inflammation and goblet cell function in patients following corneal refractive surgery.
One hundred forty-four eyes of 72 participants undergoing corneal refractive surgery were enrolled and randomized into additional 0.05% CsA eye drops treated group or conventional schedule treated group. Ocular Surface Disease Index (OSDI), relevant ocular surface clinical parameters, tear inflammatory cytokine levels, conjunctival impression cytology, and gene expression of Keratin 7 (KRT-7) as well as Mucin5AC (Muc5AC) in conjunctival epithelial cells were measured before surgery (baseline) and at 1 month after surgery. All indicators and their changing value were compared against baseline or across different groups.
0.05% CsA treatment exhibited greater changes in OSDI, NIBUT, LLT and CFS in the early postoperative period (P = 0.004, P = 0.002, P = 0.032, P = 0.008). Compared to control group, there was a more significant decrease in IFN-γ and TNF-α levels in tear fluid in CsA group after surgery (P = 0.012, p = 0.032). Additionally, KRT-7 and IFN-γ showed recovery in conjunctival cells with 0.05% CsA treatment (P = 0.003, P = 0.019). The postoperative KRT-7 and Muc5AC levels were negatively correlated with corresponding IFN-γ levels in tear fluid among all subjects (r = -0.200, p = 0.016; r = -0.229, p = 0.006).
For patients undergoing refractive surgery, the application of 0.05% CsA suppressed the expression of inflammatory cytokines such as IFN-γ and TNF-α, and preserved goblet cell function. These effects ultimately contribute to maintaining ocular surface stability and alleviating dry eye related symptoms during the early postoperative period following refractive surgery.
角膜屈光手术可实现快速视力矫正，但干眼症仍是常见的术后并发症，严重影响患者生活质量。术后干眼症的病因是多因素的。环孢素A（CsA）因其能够抑制T细胞介导的免疫反应并减轻炎症，已被用于治疗干眼症。本研究旨在评估0.05%环孢素A（CsA）滴眼液对角膜屈光手术后患者泪膜稳定性、眼表炎症和杯状细胞功能的早期影响。
纳入72例接受角膜屈光手术的参与者的144只眼，并随机分为额外的0.05% CsA滴眼液治疗组或传统方案治疗组。在手术前（基线）和术后1个月测量眼表疾病指数（OSDI）、相关眼表临床参数、泪液炎性细胞因子水平、结膜印迹细胞学检查以及结膜上皮细胞中角蛋白7（KRT-7）和黏蛋白5AC（Muc5AC）的基因表达。将所有指标及其变化值与基线进行比较或在不同组之间进行比较。
0.05% CsA治疗在术后早期的OSDI、非侵入性泪膜破裂时间（NIBUT）、泪液乳铁蛋白（LLT）和结膜荧光素染色（CFS）方面表现出更大变化（P = 0.004，P = 0.002，P = 0.032，P = 0.008）。与对照组相比，CsA组术后泪液中干扰素-γ（IFN-γ）和肿瘤坏死因子-α（TNF-α）水平下降更显著（P = 0.012，p = 0.032）。此外，0.05% CsA治疗使结膜细胞中的KRT-7和IFN-γ恢复（P = 0.003，P = 0.019）。所有受试者术后泪液中的KRT-7和Muc5AC水平与相应的IFN-γ水平呈负相关（r = -0.200，p = 0.016；r = -0.229，p = 0.006）。
对于接受屈光手术的患者，应用0.05% CsA可抑制IFN-γ和TNF-α等炎性细胞因子的表达，并保留杯状细胞功能。这些作用最终有助于在屈光手术后的早期维持眼表稳定性并减轻干眼相关症状。
