Dr. Hammersmith discussed a 2005 prospective study from Tabbara2 with six patients, half of whom were post-PK. Ganciclovir 0.15% was used twice a day for a year. There were no recurrences in the group with prophylaxis; the recurrence rate was 30% in the untreated group.
“It may be helpful in prophylaxis with or without PK,” she said. “This is small evidence, but it’s interesting.”
There is also small but growing evidence about the use of ganciclovir to treat other types of herpes and adenovirus. Ganciclovir gel may be helpful to treat pseudodendrites associated with varicella zoster keratitis. And there is limited positive evidence for its use in treating adenovirus, a common problem with few treatment options.
The clinical application of ganciclovir gel still is ripe for investigation.
“There are lots of areas of opportunity for research to enhance our understanding of utility in other applications,” Dr. Hammersmith said.
1. Wilhelmus KR. Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis. Cochrane Database Syst Rev. 2015;9;1:CD002898.
2. Tabbara KF. Treatment of herpetic keratitis. Ophthalmology. 2005;112:1640.
Kristin Hammersmith, MD