Biomedical subjects

C Baudouin

Publications and source records attributed to C Baudouin.

At least 37 records · Page 2Linked to original sources

PubMed2005

[Ultrasound biomicroscopy of posterior chamber phakic intraocular lenses: a comparative study between ICL and PRL models].

PURPOSE: To evaluate the anatomic relationships of the implantable contact lens (ICL) and the phakic refractive lens (PRL) posterior chamber phakic intraocular lenses (PCP IOL) using ultrasound biomicroscopy (UBM). MATERIAL AND METHODS: Seventeen phakic myopic eyes corrected with ICL, and 14 phakic myopic eyes that had had PRL implantation, were examined retrospectively using UBM. The main parameters measured and compared were anterior chamber depth, central and peripheral distance between PCP IOL and the crystalline lens, and exact lens haptic position. RESULTS: The mean distance between the PCP IOL and the central endothelium was 2398+/-203 microm and 2640+/-230 microm in the ICL and PRL groups, respectively. The central vault between the implant and the crystalline lens was greater in eyes with ICL (ICL, 402+/-194 microm; PRL, 256+/-187 microm, p<0.05). However, the incidence of lens contact on the peripheral level was higher in the ICL group (41%) than in the PRL group (29%), and the difference between the two implants in the peripheral crystalline lens-PCP IOL distance was significant (p<0.05). Both IOL haptics appeared to be correctly positioned in the sulcus in 13 (76%) eyes of the ICL group, and on the zonule in eight eyes (57%) of the PRL group. CONCLUSIONS: PCP IOL implantation is a safe procedure for the correction of high myopia with regard to refractive results. UBM provides a unique tool to noninvasively evaluate the relations of these implants within the posterior chamber, and helps to analyze the mechanisms of crystalline lens and iris complications.

Adult↗

PubMed2005

[Optical biometry of eyes corrected by phakic intraocular lenses].

PURPOSE: The aim of this study was to determine whether eye length measurements obtained with the IOL Master (Zeiss Humphrey) before and after phakic IOL implantation would show any changes. METHODS: In a prospective study, we used the IOL Master to measure optical biometry in 25 myopic eyes of 15 patients before and after phakic IOL implantation (PRL, ICL, Artisan). The differences between both axial length measurements were calculated and compared using a nonparametric Wilcoxon test. RESULTS: The difference between the preoperative and postoperative measurements ranged from -0.16 mm to 0.06 mm and averaged -0.016 mm, which was not statistically significant (p=0.20). Both measurements correlated in a highly positive manner (r=0.999; p<0.0001). The reproducibility of the preoperative and postoperative axial length measurements was very high (coefficient of variation=0.09% and 0.07%, respectively). The precision was 26 microm for preoperative measurements and 19 microm for postoperative measurements. CONCLUSION: Our results showed that postoperative measurements of axial length are highly comparable to preoperative measurements and that optical biometry can achieve highly precise and reliable axial length measurements in eyes with phakic IOLs. This application becomes clinically relevant in evaluating eyes with phakic IOLs that might require cataract surgery. Hence, accurate axial length measurements in eyes with phakic IOLs will be extremely important when cataract occurs in these eyes and when the preoperative measurements are no longer available.

Adult↗

PubMed2005

[Surgical controversy. Limiting preoperative scarring].

Only a better understanding of a glaucoma surgery failure will discern the indications for such surgery and improve efficacy. Any element reducing fibrosis will lower the risk of failure. In addition, the prognosis for surgery can be improved by adequate preparation of the conjunctive and the use of antimitotics--5-fluorouracile or mitomycin C--each operating on a different mechanism and whose indications should be carefully thought out. New research avenues are being explored, notably the concept of slow-release implants of antimitotics.

Cicatrix↗

PubMed2004

Comparison of morphological and functional characteristics of primary-cultured human conjunctival epithelium and of Wong-Kilbourne derivative of Chang conjunctival cell line.

PURPOSE: To analyze the relevance of a human conjunctival cell line in a study of conjunctival epithelium. We investigated and compared the effects of IFNgamma and TNFalpha in a primary culture of human conjunctiva and in a human conjunctival cell line. METHODS: A primary-cultured human conjunctival epithelium and a human conjunctival cell line (Chang cells) were treated for 72 hr with 20, 200, 400 and 600 U ml(-1) IFNgamma or with 1100 and 11,000 U ml(-1) TNFalpha. Then, the expression of HLA DR, CD40, CD44, CD63, CD80, CD86, Fas receptor, E-cadherin, ICAM-1, MUC1, cytokeratins and vimentin were investigated by flow cytometry. Cell morphology was studied with phalloidin staining. Apoptosis was detected by flow cytometry with Annexin V and via cell cycle analysis. RESULTS: The primary culture of human conjunctival epithelium expressed cytokeratin K4, non-keratinized squamous epithelial marker. Chang cells presented a more dedifferentiated phenotype and were cytokeratin K4 negative. In primary-cultured cells, IFNgamma (600 U ml(-1)) induced only a low level of apoptosis and a significant upregulation of most tested proteins such as HLA DR, Fas, ICAM-1, CD40 and CD63. In the Chang cell line, IFNgamma induced a significant level of apoptosis at concentrations of 200, 400 and 600 U ml(-1). HLA DR and CD63 were induced at lower levels than in primary-cultured cells. Other proteins were modified in a similar manner after IFNgamma treatment in both systems. In the primary-cultured cells, TNFalpha induced an important upregulation of ICAM-1, Fas and CD40 whereas CD44 and CD63 were significantly decreased. Conversely, only a very weak alteration of CD63 and ICAM-1 was observed in the Chang cell line after TNFalpha treatment. CONCLUSIONS: A primary culture of a human conjunctival epithelium demonstrated well-defined epithelial features. TNFalpha and IFNgamma, two inflammatory cytokines, induced different effects in both cellular systems, in a primary-cultured conjunctival epithelium and a human conjunctival cell line. Inflammation-related molecules were highly upregulated in the primary culture and, to a lesser extent, in the Chang cell line. Thus, the Chang cell line differs in certain features from a primary culture of human conjunctival epithelium, a fact which emphasizes the complexity of interpretation of in vitro data and this should be taken into consideration in in vitro studies of human conjunctival epithelium.

Antigens, Surface↗

PubMed2004

[Current treatments of xerophthalmia in Sjögren's syndrome].

PURPOSE: To describe the large variety of treatments currently used in Sjögren's syndrome for one of its major manifestations, keratoconjunctivitis sicca or xerophthalmia. CURRENT KNOWLEDGE AND KEY POINTS: Sjögren's syndrome causes a diffuse immunoinflammatory disturbance of main lacrimal glands and the whole ocular surface. Dry eye syndrome is responsible for chronic and deep impairment of quality of life. Many different tear substitutes have been widely developed that are poorly efficient for relieving patients from their complaints. Tear substitutes of various viscosity from standard artificial tears to synthetic gels may be used. Hyaluronic acid is currently the most promising tear substitute, but all eye drops and gels are only efficient in mild to moderate dry eyes and keratoconjunctivitis sicca mostly resists to lubricants. Moreover, the latter may increase patients' complaints when they are associated to preservatives, antiseptic drugs that have widely demonstrated their toxic or irritating potential. Preservatives are, therefore, to be avoided whenever possible in keratoconjunctivitis sicca, by using monodose disposable packaging or specific bottle filtering or eliminating the preservative. Stimulation of lacrimal and salivary secretions with systemic pilocarpine, or obturation of lacrimal puncta in order to limit the drainage of tears in lachrymal ducts may be useful in most severe forms of Sjögren's syndrome. However, the development of topical cyclosporine and other immunomodulating agents is the most relevant progress in the treatment of keratoconjunctivitis sicca in Sjögren's syndrome. PERSPECTIVES: The future for treating Sjögren's syndrome is most likely to pass through the use of new drugs capable of treating the disease or at least its mechanisms, and not only to try to relieve symptoms with poorly efficient tear substitutes.

Administration, Topical↗

PubMed2004

[Treating severe dry eye syndromes with autologous serum].

BACKGROUND: Dry eye syndrome with tear deficiency can be improved with artificial tears, which can be associated with topical anti-inflammatory agents. Autologous serum can provide the ocular surface with beneficial growth factors and vitamins. PATIENTS AND METHODS: Twenty-one patients suffering from severe dry eye due to Sjögren's syndrome were treated with 20% autologous serum for 2 Months. The Schirmer I test, break-up time, and fluorescein and lissamine green stainings were performed before and after treatment. Subjective complaints such as burning, foreign body sensation, dryness and photophobia were assessed by a questionnaire as well as a face score reflecting the current condition of patients' eyes. RESULTS: Lissamine green and fluorescein scores improved significantly as well as subjective symptoms of burning, foreign body sensation and dryness (p<0.05). The face score was significantly improved. Bacterial culture of serum delivered to the patients all remained negative. DISCUSSION: Autologous serum provides growth factors and vitamins that are useful for an altered ocular surface due to Sjögren's disease. However, some problems still remain: risk of contamination, arbitrary dilution of autologous serum, and a current lack of regulations for use of autologous serum. A close collaboration between ophthalmologists and the Etablissement Français du Sang (French Blood Bank) is mandatory because autologous serum should be considered as a useful tool to treat severe ocular surface disorders. CONCLUSION: The use of autologous serum improved symptoms and objective signs caused by severe Sjögren's syndrome. Currently, a lack of clear regulations prevents its widespread use in severe ocular surface disorders.

Blood Transfusion, Autologous↗

PubMed2004

[Intrastromal epithelial cysts of the iris: two case studies].

AIM: Intrastromal epithelial cysts, congenital or acquired, are rare tumors of the anterior chamber. We report two cases, one in a 4-Month-old girl and one in a 14-Year-old teenage girl. MATERIAL AND METHODS: In the infant case, a large cyst with a superior base obstructed the visual axis. The child had already developed amblyopia and intermittent esotropia, with normal ocular pressure. Aspiration of the cyst with complete excision was done without iridectomy. Two Years later, a secondary corectopia required an inferior iridectomy. Finally, 4 Years later, endophthalmitis developed on a corneal stitch, and the eye was enucleated. In the second case, the teenage girl had noticed a modification in her iris due to an inferior temporal iris cyst. The cyst was excised with a peripheral iridectomy. Despite a first complete excision, a recurrence the following Year was treated by Yag laser. One Year later, the clinical aspect was stable. COMMENTS AND CONCLUSION: These benign tumors present the problem of local extension and recurrence. Surgical treatment with iridectomy is often proposed despite eventual aesthetic or functional consequences. Yag laser may be a therapeutic alternative. The two operations reported here did not prevent recurrence. In conclusion, intrastromal epithelial cysts of the iris are rare and benign tumors that may induce local complications and lead to recurrence. Many treatments can be discussed for each case.

Adolescent↗

PubMed2004

[Severe bilateral capsulorhexis contraction after cataract surgery in myotonic dystrophy: a case report].

INTRODUCTION: The Authors report the case of a 50-Year-old man with myotonic dystrophy, who developed severe bilateral capsulorhexis contracture after uneventful cataract surgery. OBSERVATION: Phacoemulsification was performed in both eyes with implantation of intraocular lenses. The patient came to complain of decreased vision in both eyes (4/10 Parinaud 4). Visual acuity initially improved after surgery to 8/10 P2 in each eye. After 7 months for the right eye and 3 Months for the left eye, the patient presented with dramatically reduced vision, caused by a severe capsulorhexis contracture. Anterior capsulotomies with the Nd:YAG laser were performed in both eyes to treat this complication. It was sufficient on the left eye but the right eye required a surgical anterior capsulectomy to remove the IOL and the bag and put in an Artisan lens. DISCUSSION: Capsulorhexis contracture results from fibrous metaplasia of lens epithelial cells from the anterior capsule. Myotonic dystrophy appears to predispose to the development of severe capsulorhexis contracture after phacoemulsification.

Capsulorhexis↗

PubMed2004

[Initial medical treatment: beta-blockers or prostaglandins. Prostaglandins: a modern glaucoma treatment].

In the initial treatment of glaucoma, prostaglandin analogs have indisputable advantages: better efficacy than timolol--particularly for inducing low or even very low IOP--but also their possible use in normotensive glaucoma, posology of a single instillation per day, and no systemic effects. The only disadvantages are minor local effects and a higher cost than beta-blockers.

Adrenergic beta-Antagonists↗

PubMed2004

[Hormonal regulatory influence in tear film].

Tear film quality depends on fine regulatory mechanisms affected by neuronal and hormonal influences. Indeed, receptors for androgens, estrogens, progesterone and prolactin have been identified in several ocular tissues in the rat, rabbit and in humans. The eye is thus a target organ for sex hormones, particularly the androgens. These hormones regulate the immune system, the morphology and secretory functions of lacrimal glands and the functioning of Meibomian glands. The influence of hormone replacement therapy in menopausal women remains unclear, as some authors support the idea that they improve the quality and the volume of tear film, whereas others have shown that they increase the risk of dry eye. Finally, knowledge of the interactions between the hormones that influence the lacrimal glands is essential for the understanding of the regulation of lacrimal gland function. However, the data presently available strongly suggest that optimal bioavailable androgen levels are essential for normal lacrimal gland function and that prolactin and estrogens also play important roles in providing a hormonal milieu that contributes to normal lacrimal gland function.

Animals↗

PubMed2004

[Advantages of the in vivo HRT2 corneal confocal microscope for investigation of the ocular surface epithelia].

PURPOSE: To show the advantages of the in vivo HRT2 confocal microscope corneal module for studying the superficial and peripheral corneal and conjunctival epithelia. MATERIAL AND METHODS: We examined 15 patients whose superficial cornea was healthy and ten patients with keratoconjunctivitis sicca and/or rosacea. Some conjunctival imprints where taken on patients with superficial ocular disease and examined by immunofluorescence. RESULTS: We found superficial corneal epithelial cells, corneoconjunctival Langerhans and dendritic cells, goblet cells, limbic epithelial junction, new blood vessels, as well as deeper corneal structures such as Bowman's membrane, keratocytes, corneal nerves, and endothelium. We also observed pathological corneal epithelium in keratoconjunctivitis sicca and substantial inflammatory and vascular changes in rosacea. In two cases of stem cell deficiency associated with rosacea, we observed goblet cells in the corneal epithelium. An interesting anatomical-clinical parallelism between in vivo confocal microscopy images and those obtained by ex vivo immunofluorescence was observed. DISCUSSION: Central corneal pictures after explorations by in vivo HRT2 confocal microscopy are similar to those obtained with standard confocal microscopy. But conjunctiva, peripheral cornea and limbus are better examined at the surface and at medium depth with the HRT2. Diagnosis and therapy of superficial corneoconjunctival and limbal diseases are therefore made easier in vivo.

Conjunctiva↗

PubMed2004

[An evaluation of blebs after filtering surgery with the in vivo confocal microscope].

PURPOSE: To describe blebs after filtering surgery with a new in vivo confocal microscope. METHODS: We retrospectively evaluated 20 filtering blebs of 17 patients after trabeculectomy or deep nonpenetrating sclerectomy. Ophthalmological examinations included slit-lamp examination, applanation tonometry and in vivo confocal microscopy imaging (Heidelberg Retina Tomograph II Rostock Cornea Module). Eyes were classified into three groups: filtering blebs (eight eyes), nonfiltering blebs that were encapsulated or flat (seven eyes) and filtering blebs with mitomycin C (five eyes). In vivo confocal microscopy images were compared to the morphological and functional aspects of filtering blebs. RESULTS: Filtering blebs had numerous intraepithelial microcysts, whereas nonfiltering blebs had none or few. However, few microcysts were seen in the encapsulated filtering blebs. The connective tissue of filtering blebs was arranged loosely, whereas it was dense in nonfiltering blebs. Filtering blebs with mitomycin C had numerous microcysts and loosely arranged subepithelial connective tissue. CONCLUSION: By evaluating filtering blebs at the cellular level, this original method is highly consistent with ex vivo histological examination. In vivo confocal microscopy constitutes a new promising way to understand the wound healing mechanism in filtering surgery.

Adult↗

PubMed2003

Hyperlordosis as a possible factor in the development of spinal cord infarction.

A patient developed persistent symptoms and signs suggestive of partial spinal cord infarction after an operation involving the use of the hyperlordotic position. This position involves extension at the waist, such that both the head and feet are below the level of the waist. It is employed to increase surgical access to the abdomen. Where this position is adopted for a prolonged surgical procedure, existing risk factors for spinal cord ischaemia should urge caution in the use of epidural analgesia.

Adult↗

PubMed2003

Changes in medical and surgical treatments of glaucoma between 1997 and 2000 in France.

PURPOSE: To analyze quantitative changes in glaucoma treatment strategies between 1997 and 2000 in France. METHODS: Numbers of ab externo trabeculectomies and other glaucoma surgeries were extracted from the national database of the French Diagnosis Related Group system, which includes data for both public and private hospitals. Mean lengths of stay and hospital costs were estimated using national cost scales published by the French Ministry of Health. Numbers of patients treated per year with latanoprost, brimonidine, or the fixed combination of dorzolamide + timolol were estimated from drug unit sales using defined daily doses for each drug. RESULTS: Between 1997 and 2000, the number of patients treated with a glaucoma drug increased from 410,000 to 734,000 patients per year. This increase was associated with the introduction of three new glaucoma drugs: 245,000 patients received latanoprost (71.0%), brimonidine (28.8%), or the fixed combination of dorzolamide + timolol (0.2%). During the same period, the surgery rate in patients receiving medical treatment declined by 47%, from 5.9% to 3.1% . The total number of glaucoma interventions declined by 4.6% (-12% in public hospitals and 0% in private hospitals). This relative stability resulted mostly from a shift from trabeculectomies to other procedures, mainly to new filtering procedures in private hospitals. CONCLUSIONS: Between 1997 and 2000, new glaucoma drugs, primarily latanoprost and brimonidine, improved intraocular pressure control and delayed surgery, reducing the glaucoma procedure rate in patients receiving glaucoma-related medical treatment by 47%.

Antihypertensive Agents↗

PubMed2003

[Molteno implant and refractory glaucoma. Evaluation of postoperative IOP control and complications with a modified surgical procedure].

BACKGROUND: Management of refractory glaucoma is difficult because classic medical and surgical treatments are ineffective in controlling highly elevated intraocular pressure (IOP). Drainage implants are an alternative to cyclodestructive procedures in refractory glaucoma. The double-plate Molteno implant, a tube linked to two polypropylene plates, allows aqueous humor drainage from the anterior chamber towards the posterior subconjunctival spaces. The main postoperative complication is severe hypotony, potentially responsible for a decrease in visual acuity in cases of advanced glaucoma. Surgical modifications such as external tube occlusion can reduce postoperative hypotony. However, tube occlusion may lead to transient postoperative hypertony. Our retrospective study reports on double-plate Molteno implantation with intraoperative external tube occlusion associated with trabeculectomy in some cases. MATERIAL AND METHODS: Thirteen eyes of 13 patients with refractory glaucoma were included in the study (5 cases of open angle glaucoma, 7 cases of secondary glaucoma, one case of primary congenital glaucoma). All had ocular hypertony despite maximal tolerable medical treatment; 84.5% had previously undergone trabeculectomy with mitomycin (1-5 procedures) and 61% had undergone cyclophotocoagulation (1-4 sessions). All underwent double-plate Molteno implantation with external tube occlusion between 1993 and 2001. In three cases, intraoperative trabeculectomy was also performed. Visual acuity, IOP, relevant medical treatment and potential complications were reported at each follow-up visit. Complete success was defined as IOP less than 21 mmHg without treatment, while IOP control with medical treatment was considered as relative success. RESULTS: Mean (+/-SD) follow-up was 2.9+/-2.1 years (range, 9 months to 8 years). Mean (+/-SD) initial and final IOPs were 35.2+/-7 mmHg and 17.1+/-5 mmHg, respectively, i.e., a 50% IOP decrease. Mean (+/-SD) initial and final medical treatments were, respectively, 4.3+/-1.5 (61% with systemic acetazolamide) and 1.3+/-1.4 (without acetazolamide). The complete success rate was 38.5% and relative success 92.3%. Immediate postoperative hypertony occurred in 60% of the cases with external tube occlusion alone (10 cases). This hypertony was controlled with medical treatment in 2/3 of the cases but required surgical reintervention in 1/3 of the cases. For patients with intraoperative trabeculectomy (3 cases), postoperative immediate IOP without medical treatment was 2, 5 and 8 mmHg respectively. Complications reported were flat anterior chamber (1 case), visual acuity decrease (4 cases), lens opacification (1 case), macular edema (1 case), corneal edema (2 cases: 1 transient, 1 corneal decompensation) and long-term refractory hypertony (1 case). CONCLUSION: The double-plate Molteno implant is effective in controlling IOP in refractory glaucoma. External tube occlusion prevents complications related to excessive filtration; however, it may lead to transient postoperative hypertony. This hypertony can be avoided when simultaneous trabeculectomy is performed. Corneal decompensation remains the major complication of this surgical procedure.

Acetazolamide↗

PubMed2003

[Creating a specific diagnostic and quality-of-life questionnaire for patients with ocular surface disease].

INTRODUCTION: Ocular surface diseases (OSD) affect about 15% of the population over 65 years of age. Nevertheless, OSD knowledge in the scientific community remains poor, and the healthcare system does not adequately recognize this disorder. However, many patients with OSD suffering from chronic pain experience substantial alteration in their quality of life (QoL). PURPOSE: Our work aimed at developing a patient self-evaluation questionnaire specific to OSD. This questionnaire could thus become a useful diagnostic tool that ophthalmologists could employ in daily practice in order to better understand patients'complaints and thereby correctly treat their disease. It also may serve as an evaluation tool in medical research. This article describes the phases of item generation, validation by experts, and identification of dimensions in the QoL section. METHODS: The questionnaire was developed in French by a group of experts including clinicians and methodologists. It comprised two parts: one on diagnostic aid, and the other on subjective perception of the disease (symptoms, perception of treatment, quality of life). The questionnaire was tested on five patients. It was then modified according to the patients' suggestions and tested again on 20 patients. After a second review by the scientific committee, a pilot questionnaire suitable for systematic use in quantitative studies was prepared. A cross-sectional observational study then identified the statistical dimensions of the QoL section, which led to a reduction in the total number of items. RESULTS: The resulting operational version of the questionnaire included four sections CONCLUSION: The next study will test the reproducibility of the operational version of the OSD questionnaire obtained after the item reduction phase.

Adult↗

PubMed2003

[Apoptosis and the ocular surface].

Apoptosis, or programmed cell death, is an active phenomenon that plays a major role in most mechanisms of regulation, differentiation and wound healing. Mostly studied in the retina, apoptosis is also extensively involved in the anterior segment, especially the ocular surface. Apoptosis of keratocytes is a rapid phenomenon following excimer refractive surgery. Any epithelial aggression stimulates a series of mechanisms leading to death of deep keratocytes. The role of epithelial cell mediators may explain the superiority of LASIK compared to PRK in terms of functional rehabilitation. Conjunctiva is also a major site in which inflammation and apoptosis are combined. Proinflammatory cytokines may both amplify immune reactions and stimulate epithelial apoptosis, which is most likely to result in elimination of injured tissues. Toxic drugs also play a major role and iatrogenic apoptosis should be avoided as much as possible, especially by eliminating preservatives from eyedrops, most of which use both proinflammatory and proapoptotic agents.

Apoptosis↗

PubMed2003

[Flow cytometry in impression cytology during keratoconjunctivitis sicca: effects of topical cyclosporin A on HLA DR expression].

PURPOSE: Immune-based inflammation has been observed as a common mechanism of keratoconjunctivitis sicca (KCS). In KCS-affected eyes, up-regulated expression of HLA DR by conjunctival epithelial cells has been demonstrated in impression cytology (IC) specimens using a technique of flow cytometry. The purpose of this study was to monitor the effects of topical cyclosporin A on the expression of this marker over a 12-month period of treatment. METHODS: Patients with moderate-to-severe KCS included in a large European multicenter clinical trial (Cyclosporin Dry Eye Study, Allergan, Irvine, CA) underwent collection of IC specimens at baseline, month 3, month 6, and month 12. They randomly received 0.05% or 0.1% cyclosporin A or vehicle. Patients randomized to receive vehicle received 0.1% cyclosporin A from month 6 onwards. Specimens were processed and analyzed in a masked manner by flow cytometry, using monoclonal antibodies directed to HLA DR. RESULTS: We included 169 patients in this study. HLA DR expression, both in percentage of positive cells and level of expression, was highly significantly reduced after 0.05% and 0.1% cyclosporin A treatment at months 3, 6, and 12 compared with baseline values, whereas vehicle did not induce any change in HLA DR expression over time. The 0.05% and 0.1% cyclosporin emulsions were significantly more effective than the vehicle in reducing HLA DR at months 3 and 6 (0.05%) and at month 6 (0.1%). CONCLUSIONS: Topical cyclosporin A strikingly reduced HLA DR, whereas the vehicle, used as a control tear substitute, had almost no effect. This study confirms that cyclosporin A may be effective in reducing conjunctival inflammation in moderate-to-severe KCS and is consistent with clinical results in this indication.

Administration, Topical↗