Topical Ganciclovir Versus Systemic Acyclovir in Herpetic Keratitis: A Prospective Randomized Controlled Trial
نویسندگان
1 Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt
2 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
3 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
4 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
5 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
6 Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
7 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
8 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
9 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
10 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
11 Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
doi
10.48309/jmcs.2026.546072.2870چکیده
Herpetic keratitis remains a leading cause of corneal morbidity worldwide, and although both topical and systemic antivirals are used in its management, the comparative efficacy and safety of these approaches remain under investigation. This prospective randomized controlled study, conducted at the Ophthalmology Department of Al-Azhar University, Egypt, included 20 consecutive cases of herpetic keratitis between November 2024 and February 2025. Patients without clinical improvement after initial treatment were randomized into two groups: Group 1 received topical ganciclovir, and Group 2 was treated with systemic acyclovir. All patients were monitored for adverse effects and followed up at 4, and 6 weeks after treatment. Complete resolution at 4 weeks was significantly higher in Group 1 compared with Group 2 (80% vs. 60%, P = 0.001), and at 6 weeks, the overall improvement rate was also significantly greater in Group 1 (100% vs. 80%, p < 0.03). Adverse events were less frequent in Group 1 compared with Group 2 (20% vs. 30%, P = 0.4). These findings suggest that topical ganciclovir is more effective and better tolerated than systemic acyclovir in the treatment of herpetic keratitis, providing faster symptom resolution and fewer side effects.
