Low-dose Topical Mitomycin-C in the Treatment of Severe Vernal Keratoconjunctivitis

Abstract

Background: Corticosteroids and mast–cell stabilizers are commonly used in treatment of vernal keratoconjunctivitis (V.K.C), but regarding the side – effects of the agents and poor response in severe cases, the aim of this study was to investigate the effect of low dose topical mitomycin- c 0.01% in the treatment of severe vernal keratoconjunctivitis.

Methods: In a double blind randomized clinical trial, 40 patients with V.K.C were randomly assigned to two equal size groups. One group received topical 0.01% Mitomycin-C and another group received placebo. Complaints (tearing, itching, and mucosal discharge) and symptoms (papillae, Micropannus, hyper injection, corneal and limbus involvement) were assessed at the baseline and 2 weeks after treatment in two groups. Data were analyzed by statistical methods in SPSS.16.

Result: 40 patients were studied including 31 male and 9 female with average of 14.7 ± 3.8 years in case group and 16.2 ± 8.4 in control group. The mean disease duration in case group was 3.5 ± 3.2 years and in control group was 15 ± 4.6. Comparing the severity of complaints and symptoms two weeks after treatment in two groups, there was a statistically significant difference in the tearing (p = 0.029) and the size of papillae (p = 0.006). There wasn’t significant difference on other complaints and symptoms between two groups and no adverse effects of treatment with Mitomycin-C were observed.

Conclusion: This study showed that use of topical mitomycin-C 0.01% along with usual routine drugs reduces the severity of tearing and the size of papillae and it may be considered as a conventional treatment on patients with severe V.K.C.