title: Systematic review and meta-analysis of randomised clinical trials on topical treatments for vernal keratoconjunctivitis.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of currently available topical drugs for vernal keratoconjunctivitis (VKC) through a meta-analysis of randomised 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; 10 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
  
  
  METHODS
  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. The quality of the trials was assessed by the Delphi list. Statistical analysis was performed using STATA software.
  
  
  RESULTS
  A 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 standardised criteria among studies.
  
  
  CONCLUSIONS
  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 a need for standard criteria to assess diagnosis and therapy based on severity. There is also a need for RCTs assessing long-term effects of single drugs to control the disease and to prevent complications.
authors.affiliation: Department of Ophthalmology, University of Rome "Campus Bio-Medico", Via Emilio Longoni 83, 00155 Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Mantelli
authors.forename: M S
authors.initials: MS
authors.lastname: Santos
authors.forename: T
authors.initials: T
authors.lastname: Petitti
authors.forename: R
authors.initials: R
authors.lastname: Sgrulletta
authors.forename: M
authors.initials: M
authors.lastname: Cortes
authors.forename: A
authors.initials: A
authors.lastname: Lambiase
authors.forename: S
authors.initials: S
authors.lastname: Bonini
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D050256:Antimitotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use; D008407:Mast Cells / Q000187:drug effects; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D050256:Antimitotic Agents; D006634:Histamine H1 Antagonists; D007155:Immunologic Factors; D009883:Ophthalmic Solutions