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May 27, 2006
Dry eye therapies improve stromal HSK frequency, severity
Ophthalmology Times May 15, 2006
Norfolk, VA—Topical cyclosporine emulsion 0.05% (Restasis, Allergan) and/or punctal occlusion may be considered for the management of stromal herpes simplex keratitis (HSK) and concomitant dry eye, said John D. Sheppard, MD.The suggestion for using those modalities was based on the findings of a retrospective study that found both punctal occlusion and topical cyclosporine independently reduced the frequency and duration of HSK recurrences. A third subgroup of patients who had previously undergone punctal occlusion was also observed to benefit with reduced frequency of HSK recurrences after starting topical cyclosporine, although duration of the recurrent episodes was not significantly reduced.......In the year prior to treatment with either occlusion or cyclosporine, the mean annual HSK recurrence rates in the punctal cautery, cyclosporine, and punctal cautery + cyclosporine groups were 2.1, 1.8, and 0.58 episodes/year, respectively. During follow-up, the mean annual HSK recurrence rate was reduced significantly to ≤0.45 episodes/year in both the punctal cautery and cyclosporine groups. Among patients who began cyclosporine treatment after punctal cautery, there was also a minimally significant reduction in the mean recurrence rate to 0.40 episodes/year.The mean duration of HSK recurrences in the punctal cautery, cyclosporine, and punctal cautery + cyclosporine groups were 3.4, 3.2, and 2.2 months, respectively. A reduction in recurrence duration was also observed in all three groups, although only the changes in the punctal cautery and cyclosporine groups were statistically significant. During follow-up, mean recurrence durations in the three treatment groups were 2.4, 2.5, and 2.0 months, respectively.
Posted by mehdi khanlari at May 27, 2006 10:31 PM