UK Keratoconus Self-Help and Support Association

Hi there
I am new to the group. My doctor has prescribed cyclosporin a ointment apparently used on animals in the US and only available directly from the hospital pharmacy here

Is anyone else using this for dry eye?

I have been offered a partial cornea transplant, intac for one eye and a second cataract operation. It is all too overwhelming for me. I don't know what to do. Any advice would be welcome.

Alison

Hello Alison

Welcome to the forum. I had heard of cyclosporin eye drops being used in veterinary medicine. I thought it was an anti-inflammatory rather than an artificial tear (?)

I know we'd all be interested to hear how you get on; especially since some of us have bad reactions to steroid eye drops. Cyclosporin may be the answer that some of us have been seeking.

Andrew

Hello again, Alison

I was just re-reading your post and see that you have been offered three procedures. Are these for the same eye?

A partial thickness graft is a procedure where they peel away the top two layers of your own cornea (the outer 'skin' or epithelium and the main body of the cornea or the stroma). This leaves behind the membrane of cells that separate your cornea from the inside of your eye.

They then sew into place the new tissue that will, over time, heal onto your eye. Recovery from this sort of surgery can take a long time (several months, and even as much as a year and a half), but you do get some use of your eye long before the new tissue has become completely part of your eye.

I wonder whether the INTACS have been offered for your other eye? This procedure involves inserting one or two small semi-circles of intert plastic into your eye in order to flatten the bulge on your cornea.

I guess you know well enough what is involved in cataract surgery.

All the best

Andrew

I have heard in college bout this drug been used in dry eye treatment , it has been known to work wonders in the veterinarian world , however some doctors do feel not enough trials have been done with regards to humans. i would say defo give it a try and hopefully the results will be good

best of luck

Are you reffering to Cyclosporin Ophthalmic Emulsion? it is branded under the name RESTASIS and to the best of my knowledge is not widely available(if at all) on the NHS in the UK. There are certainly many research reports from the USA claiming fantastic results with the treatment.

I know pricate prescriptions have been issued for Restasis and they have had to pay a reasonable amount for these drops. In finding how to get these for one memeber the resident pharmacist at work told me the larger branches of Boots were the best and that you need to quote that they are available through the international pharmacist.

Pretty sure there are vareous laws regarding the use of vetinary products on humans and visa versa.

Ciclosporin (which seems to be called that under some spelling rationalisation scheme, is an immunosuppressant drug.
It's used in transplants (kidney, liver, heart, etc) to prevent or treat rejection. It also has a role in treatment of some forms of cancer, amongst other uses.
It has a whole long list of possible side effects, including strong warnings about possible adverse effects on the kidneys.
I've never heard of a ciclosporin product being used as dry eye treatment, but it's propably used in some form for corneal grafts for people who have had previous rejections and get put onto full-scale immunosuppressants, rather than just steroid anti-inflammatories.
Which could be why they have them in hospital pharmacies where they do transplants.
I am not a pharmacologist.
As regards veterinary products......
one of the problems of course is that a dose of anything designed to be effective on something like a horse of a cow is likely to overpower a human!
I'm told there are some drugs that vets use on horses which they can (or should) only use with the antidote prepared and ready to hand to stick in themselves PDQ - in case the horse proves unruly and fights and the vets ends up with the needle in the vet by mistake.
I've also heard of someone who tried taking a horse-strength painkiller and was asleep for the next three days. (A sachet of "bute" to be exact. Duke has been having two a day in his meals because of having his feet cut back so much and is full of beans and kicked me flying......
Rosemary

RESTASIS is not to be found in the online British National Formulary.
Makes note to self: locate and log onto vets' equivalent.
ciclosporin is used as treatment for eczema and psoriasis - presumay to dampen down immune response that causes auto immune disease.
Also apparently in rheumatism and gout!
Rosemary

Please go to www.restasis.com where you will find all the product information you require. You will indeed see that the Ophthalmic version is solely intended for human use and is NOT the same drug as is used on animals as an Immunosuppressant .I do have an Optometrist friend who ordered some Restasis from the USA almost two years ago now and found it to be wonderfull. Many in the States do view the treatment as a wonder treatment and a simple google search will find many research reports to help you make up your own mind.

SOrry if this was not clear from my earlier post.....
comments on ciclosporin relate to its use in HUMANS not horses!! or cattle, or any other species.
I presume that people put on ciclosporin as immuno-suppressant for corneal grafts because of rejection history are put on tablets normally, hence lack of listing of eye drop products, then??
- unless some transplant-doing hospitals import the US product specially.
I think I've read someone here posting about taking ciclosporin after a repeat transplant.
I have a nasty feeling that, if I ever get a rejection episode, they might try to put me on the stuff, as I wouldn't be able to tolerate enough steroids to reverse a rejection.
This worries me intensely, in view of the long list of side-effects I've just read - not least as have serious concerns about what the steroids mayhave done to my kidneys.
An eye ointment could, of course, be preferable to systemic midication.
Do keep us posted how you get on with it.
Rosemary