The quality of evidence is downgraded by study limitations (unclear allocation concealment), by inconsistency (unexplained variability in results), and by imprecise results (few patients).
A Cochrane review [Abstract] 1 included 3 studies with a total of 58 subjects. There was significant variability between the trials in interventions, methodology and outcome measures and therefore meta-analysis was not performed. One study reported on the use of 2% (cyclosporine A) CsA in maize oil compared to maize oil and two on the use of a commercial emulsion of 0.05% CsA compared with placebo or artificial tears. Of these three studies, one showed a beneficial effect of topical CsA in controlling signs and symptoms of atopic keratoconjunctivitis (AKC), one in controlling signs of AKC and one did not show evidence of an improvement. Only 2 studies analysed the effect of topical CsA in reducing topical steroid use; one showed a significant reduction in topical steroid use with CsA, but the other did not show evidence of this improvement. No serious adverse events were reported in the trials.
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