Treatment of Sjogren's syndrome dry eye using 0.03% tacrolimus eye drop: Prospective double-blind randomized study

Objective: To describe the clinical efficacy of the treatment of Sjogren's syndrome dry eye using 0.03% tacrolimus eye drop. Design: Prospective double-blind randomized study. Setting: Institutional outpatient clinic. Participants: Forty-eight eyes of twenty-four patients with dry eye related to Sjogren syndrome were enrolled in this study. The patients were randomized in 2 groups: tacrolimus (n= 14) and vehicle (n=10) group. Intervention: The tacrolimus group received a vial containing tacrolimus 0.03% (almond oil as vehicle) and the other group received the almond oil vehicle. All patients were instructed to use the eye drops every 12 h in the lower conjunctival sac. Main outcome measures: Schirmer I test, break-up-time (BUT), corneal fluorescein and Rose Bengal staining scores were evaluated in all patients one day before the treatment (baseline), 7, 14, 28 and 90 days after treatment with the eye drops. Results: The average fluorescein and Rose Bengal scores improved statistically after 7 days of treatment and even more after 90 days. The average Schirmer I and BUT values were unchanged after 7, 14 and 21 days but did show an improvement relative to baseline after 28 days of treatment. Schirmer I, BUT, fluorescein and Rose Bengal did not show any statistical significance in the vehicle group. Conclusion: Topical 0.03% tacrolimus eye drop improved tear stability and ocular surface status in cases of inflammatory or SS-related dry eye. Trial registration: ClinicalTrials.gov Identifier: NCT01850979. (C) 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.