To investigate the effect of postoperative administration of topical cyclosporine A 2% on surgical success of trabeculectomy as solo anti-inflammatory drug.

In a randomized clinical trial, 40 subjects with uncontrolled open angle glaucoma underwent trabeculectomy were included . Postoperatively, patients were randomly assigned into two groups: topical cyclosporine A 2% and topical betamethasone 0.1% every 4 hours for the first week and then tapered over the next 5 weeks. In 6 months follow up, postoperative intraocular pressure , bleb appearance, subjective dry eye symptoms, and surgical complications were evaluated.

Preoperative IOP was 21.7±6.6 , 19.8±4.3 mmHg in group A and B, respectively (p=0.293). At postoperative month 6th, this was reduced to 11.4±2.7and 18.9±2.1mmHg in group A and B, respectively (p <0.0001). Similarly, number of anti-glaucoma medications in group A and B were 3.15±1.13 and 3.21±1.31, which was not statistically significant (p=0.878). However, 6 months after surgery, group B were using more topical anti-glaucoma medications to achieve IOP (0.50±0.89 vs. 0.05±0.22; p=0.039). No clinically significant surgical complication was observed during the 6 month follow-up.

Topical cyclosporine A 2% could have promising effects as a substitute to betamethasone in postoperative regimen following trabeculectomy in open angle glaucoma patient