ABSTRACT
This prospective hospital-based study has been conducted to evaluate the efficacy of ketotifen fumarate 0.025% eye drops in controlling the signs and symptoms of vernal keratoconjunctivitis and to compare its effect with that of commonly used combination of eye drops for vernal keratoconjunctivitis both in mild and severe cases. A total of 20 patients [40 eyes] who came to the outpatient clinics at the ophthalmology department at King Hussein Medical Center were selected during the period between January 2004 and May 2004. They were diagnosed to have vernal keratoconjunctivitis with no other ocular or systemic pathologies that might affect the results. Two groups of medications were used; ketotifen for the right eye and naphazoline with antazoline and sodium cromoglycate for the left eye. Steroids were used for both eyes at the beginning to establish a primary control and added if needed later. The patients were followed up and given scores for their signs and symptoms on the first visit and on each follow up visits, which were distributed over a period of 6 weeks. Further division of the population into two subgroups of mild and moderate-severe groups as the behavior of the drugs differs in each group of the two. Generally, similar behavior of the disease was noticed in the two groups of medications, particularly in the mild cases where ketotifen alone could achieve a satisfactory final result as that of the combination of sodium cromoglycate and naphazoline with antazoline. The improvement was noticed in all signs and symptom studied [itching, watery discharge, redness photophobia, hyperemia, papillae and corneal signs of vernal keratoconjunctivitis]. In mild cases, there was no significant difference between the two groups of medications [p>0.05]. Steroids could be avoided in the mild cases. In the severer cases, ketotifen alone was not enough in controlling the signs and symptoms and steroids were needed at frequent intervals. In severe cases the improvement was significantly better in the group using ketotifen fumarate in the symptoms of watery discharge and redness, and in the hyperemia sign [p<0.05], while other symptoms and signs improved in both groups of medications without significant difference [p>0.05]. The use of ketotifen is of an advantage over the combination of naphazoline 0.025% with antazoline 0.5%, and sodium cromoglycate 4% as it is only one bottle with a lower frequency of instillation, thus the compliance would be better, although it almost has the same price as the other two combined. The use of ketotifen is convenient for patients with mild symptoms as a solo drug after few days of steroids. In the severe cases, ketotifen alone could not be used without frequent intervals of steroids, although a significant improvement in this group was noticed over the group of combined medications in watery discharge and redness symptoms and hyperemia sign