Comparison of two different topical 0.05% cyclosporine A formulations on ocular surface outcomes following pterygium excision with conjunctival autograft

A topical 0.05% cyclosporine A (CsA) nanoemulsion formulation was developed to improve tolerability and efficacy. However, its role in preventing recurrence and improving ocular surface parameters after pterygium surgery remains unclear. This study aimed to compare the efficacy and safety of 2 different topical 0.05% CsA formulations following pterygium excision with conjunctival autograft. This retrospective comparative study included patients who underwent pterygium excision with conjunctival autograft using fibrin glue by a single surgeon between January 2021 and June 2024. Postoperatively, patients were administered either 0.05% CsA emulsion (CsA-E; Restasis®, Allergan Inc., Irvine) or 0.05% CsA nanoemulsion (CsA-NE; Cyporin N®, Taejoon Pharm Co., Ltd., Seoul, Republic of Korea) twice daily for 12 months. The primary outcome was the recurrence rate of pterygium at 12 months postoperative. Secondary outcomes included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, tear meniscus height (TMH), and adverse events. A total of 202 eyes (202 patients) was analyzed: 96 in the CsA-E group (60 males, 36 females; mean age, 65.6 ± 8.2 years) and 106 in the CsA-NE group (64 males, 42 females; mean age, 65.2 ± 8.4 years). There were no significant differences in baseline characteristics between the 2 groups. The recurrence rate was 8.3% in the CsA-E group and 3.8% in the CsA-NE group, with no statistically significant difference (P = .235). Postoperative VA outcomes were comparable between the groups; the median CDVA was 0.04 logMAR in both groups (P = .175). Notably, TMH values in both groups significantly decreased compared to baseline (both P <.001), normalizing to within the physiological range, with no significant difference in the magnitude of reduction between the groups (P = .641). No severe adverse events were reported in either group. Both CsA formulations were effective in preventing pterygium recurrence with comparable safety profiles. Additionally, both groups achieved excellent and comparable postoperative VA.