[Nonpreserved topical steroids and lacrimal punctal occlusion for severe keratoconjunctivitis sicca].
OBJECTIVE
To analyze the efficacy of topical nonpreserved steroids before punctal occlusion in the treatment of severe keratoconjunctivitis sicca associated with Sjögren's syndrome.


METHODS
We performed a prospective study including 15 patients, 30 eyes, (group 1) treated with topical nonpreserved steroids for 2 weeks and then punctal occlusion, and 15 patients, 30 eyes, (group 2) treated directly with punctal occlusion. Symptom severity (0-3+) and corneal fluorescein staining (0-9+) were evaluated after a week and after two months, and results were statistically compared between both groups with the t Student test.


RESULTS
Symptom severity was negative in 67% of patients of group 1 and in 27% of patients of group 2 (p=0.0001 ) after a week, and in 80% of patients in group 1 and in 33% of patients of group 2 (p=0.0003) after 2 months. Corneal fluorescein staining was negative in 67% (OD) and 73% (OI) of patients of group 1 and in 33% (AO) of patients of group 2 (p=0.0001, AO) after a week, and in 80% (AO) of patients of group 1 and in 60% of patients of group 2 (AO) (p=0.0001, AO) after 2 months. There were no patients with side effects or complications.


CONCLUSIONS
Topical nonpreserved steroid therapy for two weeks before punctal occlusion is effective in controlling symptoms and corneal fluorescein staining in patients with severe keratoconjunctivitis sicca associated with Sjögren's syndrome.
Sainz De La Maza Serra M
Servicio de Oftalmología, Unidad de Inmunología Ocular y Uveítis, Hospital Clínico y Provincial de Barcelona, España.
Simón Castellvi C
Kabbani
O
O
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000628:therapy*; D007765:Lacrimal Apparatus; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D012720:Severity of Illness Index; D012859:Sjogren's Syndrome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids