Efficacy of topical ganciclovir as therapeutic alternative in epithelial herpetic keratitis. Randomized clinical trial Eficacia del ganciclovir tópico como alternativa terapéutica de la queratitis epitelial herpética
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© 2013 Sociedad Mexicana de Oftalmología. Objective: To compare the healing rate in less than 7 days with the use of ganciclovir or acyclovir in patients with epithelial herpetic keratitis. Materials and methods: We designed a randomized clinical trial including patients with epithelial herpetic keratitis seen at Centro de Oftalmología de la Fundación Santos y de la Garza Evia. There were 2 treatment groups: 0.15% ganciclovir gel and acyclovir 3% ointment, applied 5 times a day until the dendrite closed, and then 3 times a day for 3 days. We evaluated patients daily until the ulcer healed. A validated symptom scale was provided in each visit. Results: We recruited 23 patients: 13 treated with ganciclovir (56.5%) and 10 (43.4%) with acyclovir (P =.94), the mean age was 47.69 years (SD ± 18.6) for the first group, and 56.8 years (SD ± 9.6) for the second (P =.17). The initial ulcer size was similar in both groups: 2.3 mm (± 1.85) in acyclovir and 3.0 mm (± 0.94) in ganciclovir. On the first day the median ulcer size was 1.5 mm acyclovir (IQR = 1.8) and ganciclovir 1 mm (IQR = 1.9) (P = 0.257), which does not show a clinically significant difference. At day 7, the ulcer had closed to 0 mm (IQR = 0) in all cases of ganciclovir compared with acyclovir 1 mm (IQR = 1.7) (P =.000). Conclusions: The healing rate of ganciclovir in less than 7 days for EK was superior compared with acyclovir.