Use of episcleral cyclosporine implants in dogs with keratoconjunctivitis sicca
Fonte: Laura Barachetti, Antonella Rampazzo, Carlo M. Mortellaro, Stefania Scevola and Brian C. Gilger
One of the PC cases, the eye of an English bulldog.
To describe the use, tolerability, and efﬁcacy of episcleral silicone matrix cyclosporine (ESMC) implants in dogs with keratoconjunctivitis sicca (KCS).Methods Retrospective study. ESMC implants (1.9 cm length, 30% wt/wt CsA in silicone; with approximately 12 mg of CsA loaded into them) were used in dogs with KCS responsive to topical CsA (good candidate, GC) or not responsive (poor candidate, PC). Ocular surface inﬂammation scores, Schirmer tear test (STT) values,and ocular discharge quantity were evaluated and compared.Results Twenty-seven eyes (15 dogs) received an ESMC implant for KCS; 15 eyes were considered GC, and 12 were considered PC. Both GC eyes and PC eyes showed a signiﬁcant increase in STT values (increase of 7.7 and 8.5 mm/min; P = 0.023 andP = 0.003, respectively) after placement of ESMC implants (mean follow-up 18 2and 10.4 15 months, respectively). Clinical signs improved signiﬁcantly in both groups during the same follow-up, with reduction in conjunctival hyperemia(P < 0.001), corneal neovascularization (P = 0.004), corneal opacity (P = 0.003), and ocular discharge (P = 0.002). ESMC implants were well tolerated by all dogs, but two eyes lost the device at 12-months and 1-w eek follow-up, respectively. Conclusions: Results from this study suggest that the EMSC implants were well tolerated and efﬁcacious in dogs with KCS responsive to topical CsA as well as dogs with poor response to topical therapy. Further study is needed to determine the duration of efﬁcacy and optimal dose of CsA.