Topical cyclosporine A 0.5% as a possible new treatment for superior limbic keratoconjunctivitis

Purpose: To report the early success of the use of topical cyclosporine A 0.5% drops to treat Theodore's superior limbic keratoconjunctivitis (SILK). Design: A retrospective noncomparative case series. Participants: Five patients diagnosed with SILK. Intervention: All five patients were treated with topical cyclosporine A 0.5% drops as primary or adjunctive therapy after treatment failure in some of prednisolone acetate 1% drops and topical silver nitrate 0.5% application. Topical cyclosporine A 0.5% drops were used four times a day in both eyes. Main Outcome Measures: Resolution of symptoms (foreign body sensation and irritation) and signs (rose bengal staining, tarsal papillary reaction, and injection). Results: All five patients had long-term (6 months to 3 years) improvement of irritation and foreign body sensation, as well as improvement of injection and filamentary keratitis. Aside from burning on instillation, there were no complications related to this therapy. Conclusions: Topical cyclosporine A 0.5% is helpful as primary or adjunctive therapy for SILK. It may also be used as a maintenance drug to prevent recurrence. Further study may delineate the specific role and treatment parameters for the use of topical cyclosporine A 0.5% in the treatment of SLK. (C) 2003 by the American Academy of Ophthalmology.