Dear Editor,

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.

REFERENCES

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