Treatment of ocular rosacea: comparative study of topical cyclosporine and oral doxycycline

AIM: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints.METHODS: One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups: nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline.RESULTS: Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes(P 【0.001). Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs(P =0.01). There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group(P 【0.05).CONCLUSION: Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage.

白内障超声乳化术联合非穿透性深层巩膜切除术与联合小梁切除术的疗效比较(英文)

目的:比较白内障超声乳化术联合非穿透性深层巩膜切除术(P-DS)和白内障超声乳化术联合小梁切除术(P-T)在白内障合并中度至重度原发性开角型青光眼(POAG)或假性剥脱性青光眼(PXG)患者中的疗效。方法:前瞻随机性研究。选取40例(40眼)白内障合并POAG或PXG患者,所有患者均接受全面眼部检查和青光眼测试。每组20眼,分别在局部麻醉下行P-DS或P-T。术前,术后10d,1、3、6、12mo记录视力、眼压及青光眼用药量。并对P-DS组行激光前房角穿刺、P-T组行普通穿刺的术后并发症记录。结果:两组患者年龄(P-DS组:66.3±11.0;P-T组:70.2±9.3岁)和性别(P-DS组:女7,男13;P-T组:女9,男11)分布相似(P>0.05)。POAG和PXG患者在两组(P-DS组,P-T组)中分别为12例和8例,13和7例(P>0.05)。两组在术前视力(P-DS组:0.69±0.22 log MAR;P-T组:0.76±0.22 log MAR)、眼压(P-DS组:17.9±1.6 mm Hg;P-T组:18.1±1.9 mm Hg)及用药量(P-DS组:2.7±0.7;P-T组:2.9±0.8)差异均无统计学意义(P>0.05)。与术前相比,两组术后均出现视力提高,眼压和用药量减少的现象(P<0.01)。术后两组(P-DS组,P-T组)眼压分别为15.0±1.7 mm Hg和14.5±1.6 mm Hg(P=0.472)。术后P-T组(0.5±0.7)的用药量略少于P-DS组(0.8±0.9)(P=0.307)。两组中均无并发症。P-DS组中7眼(5眼一次;2眼两次)行激光前房角穿刺;P-T组中1眼行普通穿刺。结论:同时患有白内障和青光眼的患者行联合P-DS与PT具有一定安全性。两组的可靠性与疗效相当。对P-DS组应进行密切随访,如果有必要应行激光前房角穿刺。