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Paper Information

Journal:   JOURNAL OF CURRENT OPHTHALMOLOGY   2003 , Volume 16 , Number 1; Page(s) 101 To 108.
 
Paper: 

A COMPARATIVE CLINICAL TRIAL OF EFFICACY AND SAFETY OF TOPICAL CYCLOSPORINE-A AND MITOMYCIN-C FOR REFRACTORY VERNAL KERATOCONJUNCTIVITIS

 
 
Author(s):  HASHEMIAN M.N., RAHIMI F., MOHAMMADI S.F.
 
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Abstract: 

Purpose: Comparison of short-term efficacy and safety of topical cyclosporine-A and mitomycin-C in the treatment of refractory vernal keratoconjunctivitis.
Methods: A fellow-eye controlled trial in which topical 2% cyclosporine-A and 0.005% mitomycin-C, four times daily for four weeks were administered concurrently for fellow eyes of 21 patients.
Results: Cyclosporine-A brought about significant objective improvement relative to the baseline (P=0.012) and more objective improvement in comparison with mitomycin-C (P=0.046). Cyclosporine-A was associated with a better relative ocular comfort (P=0.003). Mitomycin-C was associated with 14 new cases/exacerbations (67%) of punctate keratopathy and five cases (24%) of hypotony. Hypotony was associated with limbal involvement, disease duration, and severity (P values<0.05). Six patients (29%) reported remarkable burning sensation following application of cyclosporine-A.
Conclusion: Topical mitomycin-C, even at low doses and in the short-term does not seem to be a safe management of vernal keratoconjunctivitis as it can result in significant punctate keratopathy and hypotony. Short-term topical Cyclosporine-A is an efficacious safe adjuvant to current modalities for severe vernal keratoconjunctivitis. Its long-term efficacy and safety (including tolerability of its pharmacological formulation) are the areas of future research and development.

 
Keyword(s): CYCLOSPORINE-A, MITOMYCIN-C, OCULAR HYPOTONY, PUNCTATE KERATOPATHY, VERNAL KERATOCONJUNCTIVITIS
 
References: 
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