Effect of topical 0.05% cyclosporine A on corneal endothelium in patients with dry eye disease

AIM:To determine the effect of topical 0.05%cyclosporine A(CsA) on corneal endothelium in patients with dry eye disease.·METHODS:Observational,prospective,case series study.Fifty-five eyes of 29 consecutive patients(9 males and 20 females;median age:66.8 years,interquartile range:61-73.2 years) with moderate-severe dry eye disease were evaluated.All patients were treated with topical 0.05% CsA ophthalmic emulsion twice a day in addition to lubricant eyedrops 5 times a day.The followup period was 12 months.Before treatment and at 3 and12 months post-treatment central corneal specular microscopy was performed.The endothelial cell density(ECD),coefficient of variation of cell size(CoV),and percentage of hexagonal cells(Hex %) were analyzed.·RESULTS:The median ECDs pre-treatment and at 3and 12 months post-treatment were 2 352.5/mm2(interquartile range,2 178-2548.5),2 364/mm2(interquartile range,2 174.25-2 657.5),and 2 366 cells/mm2(inter-quartile range,2 174.75-2 539.75),respectively(P =0.927,one way ANOVA).The median CoVs pre-treatment and at3 and 12 months post-treatment were 34.5(interquartile range,30-37),35(interquartile range,30-38),and 34(interquartile range,30.75-38.25),respectively(P =0.7193,one way ANOVA).The median Hex % values pre-treatment and at 3 and 12 months post-treatment were53(interquartile range,47-58),54(interquartile range,45.75-59),and 50.5(interquartile range,45.75-58),respectively(P =0.824,one way ANOVA).·CONCLUSION:Treatment of patients with dry eyedisease for 12 months with topical 0.05% CsA does not seem to cause substantial changes on corneal endothelium.