PURPOSE: 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.
RCT Entities:
PURPOSE: 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 cornealfluorescein 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. Cornealfluorescein 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 cornealfluorescein staining in patients with severe keratoconjunctivitis sicca associated with Sjögren's syndrome.
Authors: Mark S Milner; Kenneth A Beckman; Jodi I Luchs; Quentin B Allen; Richard M Awdeh; John Berdahl; Thomas S Boland; Carlos Buznego; Joseph P Gira; Damien F Goldberg; David Goldman; Raj K Goyal; Mitchell A Jackson; James Katz; Terry Kim; Parag A Majmudar; Ranjan P Malhotra; Marguerite B McDonald; Rajesh K Rajpal; Tal Raviv; Sheri Rowen; Neda Shamie; Jonathan D Solomon; Karl Stonecipher; Shachar Tauber; William Trattler; Keith A Walter; George O Waring; Robert J Weinstock; William F Wiley; Elizabeth Yeu Journal: Curr Opin Ophthalmol Date: 2017-01 Impact factor: 3.761
Authors: Terry G Coursey; Johanna Tukler Henriksson; Flavia L Barbosa; Cintia S de Paiva; Stephen C Pflugfelder Journal: Am J Pathol Date: 2016-04-13 Impact factor: 4.307
Authors: Stephen C Pflugfelder; William Farley; Lihui Luo; Lucy Zhuo Chen; Cintia S de Paiva; Lisa C Olmos; De-Quan Li; M Elizabeth Fini Journal: Am J Pathol Date: 2005-01 Impact factor: 4.307
Authors: Adrian T Fung; Tuan Tran; Lyndell L Lim; Chameen Samarawickrama; Jennifer Arnold; Mark Gillies; Caroline Catt; Logan Mitchell; Andrew Symons; Robert Buttery; Lisa Cottee; Krishna Tumuluri; Paul Beaumont Journal: Clin Exp Ophthalmol Date: 2020-01-22 Impact factor: 4.207