Efficacy of four antiviral agents in the treatment of uncomplicated herpetic keratitis.
OBJECTIVE: To evaluate the efficacy of four antiviral agents--1% idoxuridine ointment (group 1), 2% trifluorothymidine ointment (group 2), 3% acyclovir ointment (group 3) and 1% bromovinyldeoxyuridine (BVDU) ointment (group 4)--in herpes simplex keratitis. DESIGN: Randomized double-blinded clinical trial. SETTING: Tertiary care institution in New Delhi. PATIENTS: Eighty patients with uncomplicated herpes simplex keratitis of recent onset who had not previously received antiviral treatment. MAIN OUTCOME MEASURES: Cure rate, frequency and severity of side effects. RESULTS: Cure rates of 60%, 90%, 90% and 95% were obtained in groups 1, 2, 3 and 4 respectively. The average healing time was 13.4, 8.9, 8.5 and 7.5 days respectively. Side effects (follicular conjunctivitis, epithelial keratopathy and stinging) were more frequent in group 1 than in the other groups. CONCLUSIONS: BVDU has a more pronounced therapeutic effect than idoxuridine, trifluorothymidine and acyclovir in uncomplicated epithelial herpetic disease of recent onset that has not previously been treated.