Ganciclovir ophthalmic gel (Virgan; 0.15%) in the treatment of herpes simplex keratitis.
OBJECTIVE
Ganciclovir is a broad-spectrum virustatic agent. Its efficacy and safety after ocular application have been demonstrated in studies of herpetic keratitis in rabbits. Two strengths of ganciclovir gel (0.05 and 0.15%) were compared with 3% acyclovir ointment in the treatment of superficial herpes simplex keratitis in humans.


METHODS
Two multicenter randomized clinical trials were carried out in Africa (Trial 1) and Europe (Trial 2). Sixty-seven patients (Trial 1) and 37 patients (Trial 2) from herpetic ulceration were recruited.


RESULTS
The results showed no statistically significant difference between the treatment groups, although the healing rates tended to be better in the group receiving 0.15% ganciclovir gel, with healing rates of 85% (Trial 1) and 83% (Trial 2) as compared with 72% (Trial 1) and 71% (Trial 2) in the group receiving acyclovir ointment. Local tolerance was found to be superior with the gel formulation of ganciclovir with fewer complaints of discomfort (stinging, burning) or blurred vision after application of the drug. Systemic absorption of the drug was low. No hematologic changes were detected.


CONCLUSIONS
These findings support the efficacy of ganciclovir gel in the treatment of ulcerative herpes simplex keratitis and demonstrate its superior local tolerance when compared with acyclovir ointment.
Colin
J
J
Service d'Ophtalmologie Daviel, Hôpital Morvan, Brest, France.
Hoh
H B
HB
Easty
D L
DL
Herbort
C P
CP
Resnikoff
S
S
Rigal
D
D
Romdane
K
K
D000212:Acyclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000287:Administration, Topical; D000293:Adolescent; D000914:Antibodies, Viral / Q000032:analysis; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003315:Cornea / Q000187:drug effects / Q000821:virology; D015774:Ganciclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005782:Gels; D018259:Herpesvirus 1, Human / Q000276:immunology; D006801:Humans; D016849:Keratitis, Herpetic / Q000188:drug therapy* / Q000276:immunology; D009824:Ointments; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome
D000914:Antibodies, Viral; D000998:Antiviral Agents; D005782:Gels; D009824:Ointments; D015774:Ganciclovir; D000212:Acyclovir