ABSTRACT
Topical cyclosporin A at a 2% concentration was used for 6 months in the management of 2 patients with vernal keratoconjunctivitis who had failed to respond to conventional therapy. We used one drop every 6 hours in both eyes during the first month and every 12 hours during the remaining 5 months. Clinical controls were carried out weekly during the first month, monthly during the 6 month period and every 2 months thereafter. Cyclosporin A blood levels and serum creatinine were regularly monitored in both patients. Within the first month, both the symptoms and signs of the condition, in particular papillary proliferations, improved significantly and these results were maintained throughout the entire period of treatment and during 2 years of follow-up with conservative management (artificial tears).
Subject(s)
Conjunctivitis, Allergic/drug therapy , Cyclosporine/therapeutic use , Immunosuppressive Agents/therapeutic use , Administration, Topical , Adult , Child , Chronic Disease , Conjunctivitis, Allergic/pathology , Follow-Up Studies , Humans , MaleABSTRACT
We treated three patients with Aspergillus keratomycosis with collagen shields soaked in amphotericin B (0.50%) for 2 hours at 25 degrees C before application. These shields, replaced daily, were used in conjunction with amphotericin B (0.25%) eye drops, which were applied every 2 hours. Cultures from the eyes of all patients became negative within 15 days of treatment. Subsequently, two patients required keratoplasty. The results suggest that collagen shields prepared this way deliver an adequate concentration of amphotericin B to the cornea, aid its tolerance, and improve the prognosis of Aspergillus keratomycosis. Further studies are needed to define the minimum therapeutic concentrations necessary to inhibit the growth of the fungus and to avoid a toxic effect on the cornea.
