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Systematic review and meta-analysis of randomized clinical trials on topical treatments for vernal keratoconjunctivitis
  1. Flavio Mantelli,
  2. Myrna S Santos,
  3. Tommasangelo Petitti,
  4. Roberto Sgrulletta,
  5. Magdalena Cortes,
  6. Alessandro Lambiase,
  7. Sergio Bonini,
  8. Stefano Bonini (sbonini{at}
  1. Campus Bio-Medico University of Rome, Italy
  2. Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
  3. Campus Bio-Medico University of Rome, Italy
  4. Campus Bio-Medico University of Rome, Italy
  5. Campus Bio-Medico University of Rome, Italy
  6. Campus Bio-Medico University of Rome, Italy
  7. II University of Naples and National Research Council (CNR) of Rome, Italy
  8. Campus Bio-Medico University of Rome, Italy


    Aims: The aim of this study was to assess the efficacy of currently available topical drugs for vernal keratoconjunctivitis (VKC) through a meta-analysis of randomized clinical trials (RCTs).

    Methods: Twenty-seven RCTs (N= 2184 eyes) that had evaluated the efficacy of topical drugs for the treatment of VKC were selected according to the set criteria; ten of these trials were suitable for statistical analysis and were enrolled in the meta-analysis. Articles published up to December 2005 were identified from the following data sources: Medline, Embase, Lilacs, the Cochrane Controlled Trials Register, and references from relevant articles. Articles in any language published with an English abstract, were screened and those selected for inclusion were written in English, French, German, Italian, Portuguese or Spanish. Quality of trials was assessed by the Delphi list. Statistical analysis was performed using STATA ® software.

    Results: Significant improvement in all signs and symptoms, except photophobia, was observed after topical treatment for active VKC, independent of the type of treatment. Comparison of the efficacy of different drugs was not possible due to a lack of standardized criteria among studies.

    Conclusion: The currently available topical drugs are effective in treating acute phases of VKC. However, there is a lack of evidence to support the recommendation of one specific type of medication for treating this disorder. There is need of standard criteria to assess diagnosis and therapy based on severity. There is also need of RCTs assessing long-term effects of single drugs to control the disease and to prevent complications.

    • Meta-analysis
    • VKC
    • allergy
    • topical treatment
    • vernal keratoconjunctivitis

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