We have read with interest the article by Roberta Lilian Fernandes de Sousa Meneghim et al.(1). In response to this article(1) which is a well-thought out and written paper, I would like to draw attention to some critical points in this study. As presented in most studies, topical cyclosporine drops require at least 3-6 months for their effectiveness to begin(2-4). In the article by Meneghim et al.(1), topical cyclosporine was used for only 10 days before and after the operation. In our clinic, Mugla Education and Research Hospital, we prescribe topical cyclosporine 3 months before and 6 months after the pterygium operation. In this article(1), it seemed obvious that topical cyclosporine used for such a short time before and after the operation would not have a statistical or clinical effect.
Pterygium pathogenesis has been mainly associated with ultraviolet light exposure; however, this association remains quite controversial. The complete pathophysiology of pterygium also remains to be clarified(5). To reduce recurrences, new study and treatment methods are needed.
1. Meneghim RLFS, Satto LH, Natsuaki KL, Oliveira AC, Padovani CR, Viveiros MMH, et al. Topical cyclosporine A 0.05% before and after surgery to prevent pterygium recurrence. Arq Bras Oftalmol. 2019;82(5):372-6.
2. de Paiva CS, Pflugfelder SC, Ng SM, Akpek EK. Topical cyclosporine A therapy for dry eye syndrome. Cochrane Database Syst Rev [Internet]. 2019[cited 21 sep 2020] ;9(9):CD010051. Avaılable from: Topical cyclosporine A therapy for dry eye syndrome - de Paiva, CS - 2019 | Cochrane Library
3. Özülken K, Koç M, Ayar O, Hasiripi H. Topical cyclosporine A administration after pterygium surgery. Eur J Ophthalmol. 2012;22 Suppl 7:S5-10.
4. Hwang S, Choi S. A comparative study of topical mitomycin C, cyclosporine, and bevacizumab after primary pterygium surgery. Korean J Ophthalmol. 2015;29(6):375-81.
5. Wanzeler ACV, Barbosa IA, Duarte B, Borges D, Barbosa EB, Kamiji D, et al. Mechanisms and biomarker candidates in pterygium development. Arq Bras Oftalmol. 2019;82(6):528-36.
Submitted for publication:
November 9, 2021.
Accepted for publication: November 16, 2021.
Funding: This study received no specific financial support
Disclosure of potential conflicts of interest: The author have any potential conflicts of interest to disclose