Clinical Evaluation of Adenine Arabinoside and Trifluorothymidine in the Treatment of Corneal Ulcers Caused by Herpes Simplex Virus

One hundred two unselected patients with ulceration of the cornea due to herpes simplex virus were treated with either adenine arabinoside or trifluorothymidine; the trial was double-blind, stratified, and randomized. The two drugs were given topically five times per day, and the rate of healing was observed and recorded. The series included 87 patients with dendritic ulcers and 15 with amoeboid ulcers. Dendritic ulcers of the cornea can be accurately measured, and the healing process can be easily followed. In this situation no statistically significant difference between the efficacy of adenine arabinoside and that of trifluorothymidine was demonstrated. Amoeboid ulcers are more difficult to evaluate than dendritic ulcers, and their responses to treatment vary considerably; however, data from this small group of patients suggest that trifluorothymidine may be more effective than adenine arabinoside for the treatment of amoeboid ulcers. The use of antiviral agents in the treatment of keratitis caused by herpes simplex virus has gained wide acceptance. Idoxuridine (IDU) was first used in 1960 [1]; it has remained, until recently, the only effective antiviral agent available.