Eficacia del ganciclovir tópico como alternativa terapéutica de la queratitis epitelial herpética

Abstract

ObjectiveTo compare the healing rate in less than 7 days with the use of ganciclovir or acyclovir in patients with epithelial herpetic keratitis. Materials and methodsWe 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. ResultsWe 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: 2.3mm (±1.85) in acyclovir and 3.0mm (±0.94) in ganciclovir. On the first day the median ulcer size was 1.5mm acyclovir (IQR=1.8) and ganciclovir 1mm (IQR=1.9) (P=0.257), which does not show a clinically significant difference. At day 7, the ulcer had closed to 0mm (IQR=0) in all cases of ganciclovir compared with acyclovir 1mm (IQR=1.7) (P=.000). ConclusionsThe healing rate of ganciclovir in less than 7 days for EK was superior compared with acyclovir.