Topical Mitomycin-C 0.01% Versus Dexamethazone Phosphate 0.1% in Refractory Vernal Keratoconjunctvitis

To compare the efficacy and safety of topical mitomycin- C 0.01% versus dexamethazone phosphate 0.1% in patients with refractory vernal keratoconjunctivitis (VKC). In this double blind randomized clinical trial, patients with refractory VKC were randomly assigned to treatment with topical mitomycin-C 0.01% eye drops (N=27) or dexamethazone phosphate 0.1% (N=27), four times daily for 20 days. Symptoms including foreign body sensation, tearing, itching, mucous discharge and signs including conjunctival hyperemia, conjunctival giant papillae, limbal hypertrophy, and Trantas dots, were compared before after treatments between the two groups. There was a statistically significant decrease in signs and symptoms in the mitomycin-C group at the end of 20 days of treatment such that two cases (7.4%) of the mitomycin group and 26 cases (96%) of the dexamethazone group required another medication. (P=0.000) Short-term low dose topical mitomycin-C may be considered for acute exacerbations of severe VKC.