Low-dose Topical Mitomycin-C in the Treatment of Severe Vernal Keratoconjunctivitis

Abstract

RESULT: 40 patients were studied including 31 male and 9 female with average of 14.7 ± 3.8 years in case group and 16.2 ± 8.4 in control group. The mean disease duration in case group was 3.5 ± 3.2 years and in control group was 15 ± 4.6. Comparing the severity of complaints and symptoms two weeks after treatment in two groups, there was a statistically significant difference in the tearing (p = 0.029) and the size of papillae (p = 0.006). There wasn't significant difference on other complaints and symptoms between two groups and no adverse effects of treatment with Mitomycin-C were observed. CONCLUSION: This study showed that use of topical mitomycin-C 0.01% along with usual routine drugs reduces the severity of tearing and the size of papillae and it may be considered as a conventional treatment on patients with severe V.K.C. INTRODUCTIONSeasonal conjunctivitis is the most severe form of allergic conjunctivitis which is mostly seen in young men. The main immunological mechanism is unknown [1][2] . The prevalence of vernal keratoconjunctivitis (V.K.C) in a study conducted by Leonard et al. was estimated as 7.8 per 100,000 that was more prevalent among young men than young women [3] . Sacchetti and et al in a study stated that the quality of life in children can be directly correlated with the prevalence of V.K.C in them [4] . Also Kumar et al. discussed about new therapeutic approaches for the management of vernal keratoconjunctivitis in children [5] . The disease is usually self-limiting but sometimes they are more serious and their control is difficult. If the symptoms are not limited by themselves or cause pain to the patient, medicine is prescribed that include mast cell stabilizers and steroids. Symptoms ABSTRACT BACKGROUND: Corticosteroids and mast-cell stabilizers are commonly used in treatment of vernal keratoconjunctivitis (V.K.C), but regarding the side -effects of the agents and poor response in severe cases, the aim of this study was to investigate the effect of low dose topical mitomycin-c 0.01% in the treatment of severe vernal keratoconjunctivitis. METHODS: In a double blind randomized clinical trial, 40 patients with V.K.C were randomly assigned to two equal size groups. One group received topical 0.01% Mitomycin-C and another group received placebo. Complaints (tearing, itching, and mucosal discharge) and symptoms (papillae, Micropannus, hyper injection, corneal and limbus involvement) were assessed at the baseline and 2 weeks after treatment in two groups. Data were analyzed by statistical methods in SPSS.16.