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Topical corticosteroids as adjunctive therapy for bacterial keratitis

  • Review
  • Intervention




Bacterial keratitis is a serious ocular infectious disease that can lead to severe visual disability. Risk factors for bacterial corneal infection include contact lens wear, ocular surface disease, corneal trauma and previous ocular or eyelid surgery. Topical antibiotics constitute the mainstay of treatment in cases of bacterial keratitis where as the use of topical corticosteroids remains controversial. Topical corticosteroids are usually used to control inflammation using the smallest amount of the drug. Their use requires optimal timing, concomitant antibiotics and careful follow up.


The objective of the review was to assess the clinical effectiveness and adverse effects of corticosteroids as adjunctive therapy for bacterial keratitis.

Search methods

We searched CENTRAL, MEDLINE, EMBASE, and LILACS up to 15 January 2007. We also searched the Science Citation Index to identify additional studies that had cited the included trial, an online database of ongoing trials (, reference lists of included trials, earlier reviews and the American Academy of Ophthalmology guidelines. We also contacted experts to identify any unpublished and ongoing randomized trials.

Selection criteria

We included randomized controlled trials evaluating adjunctive therapy with topical corticosteroids in people with bacterial keratitis.

Data collection and analysis

Two review authors independently screened all the retrieved articles. Methodological quality of the one included trial was assessed using forms developed using pre-specified criteria by at least two review authors. We planned to extract data on outcomes using forms developed for the purpose. We planned to report risk ratios for dichotomous outcomes and mean differences for continuous outcomes.

Main results

A single trial was eligible for inclusion in the review. Participants in the trial were randomized using a random numbers table. Allocation concealment was not attempted. Masking of participants, and care-providers was also not attempted. Outcome assessment was conducted independently by two physicians. Neither was masked to the treatment allocation. The trial reported the healing rate of epithelial defects and improvement in visual acuity.

Authors' conclusions

There are no good quality randomized trials evaluating the effects of adjunct use of topical corticosteroids in bacterial keratitis. The only randomized trial we identified in the literature suffered from major methodological inadequacies.








我們尋找至2007年1月15日 CENTRAL, MEDLINE, EMBASE,和 LILACS資料庫。我們也搜查了科學引文的索引去確認額外的研究,包含正在進行中的線上資料庫試驗(,參考文獻中所包括的試驗,早期的綜合評論和美國眼科學的指引。我們還與專家聯繫,查明任何未發表和進行中的隨機試驗。




兩位評論的作者獨自篩選搜索文章。包括試驗本身等項目品質,至少被兩個評論作者使用預先設計好的準則來進行評估。我們計劃以目的來設計評質表格,以獲得精確的數據 。我們以危險率作為二分結果,以平均差作為連續結果。


一個試驗符合資格被納入綜合評論中。試驗的參與者被使用隨機號碼表隨機分配。未進行分配遮蔽。參加者和照護者也未遮蔽處理 。結果評估是由兩位醫生獨立進行的。對於治療分配也無遮蔽。本試驗報告角膜上皮缺損癒合速率與視力改善的相關性。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Topical corticosteroids as adjunctive therapy for bacterial keratitis

Bacterial keratitis or corneal inflammation due to bacterial infection, is a potentially sight threatening condition. Risk factors for bacterial keratitis, a serious ocular condition that can result in visual disability, include contact lens wear, ocular surface disease, corneal trauma and previous ocular or eyelid surgery. Topical antibiotics are the mainstay of treatment for bacterial keratitis. The usefulness of adjunct treatment with topical corticosteroids is controversial. We identified a single randomized trial of borderline methodological quality, evaluating adjunct corticosteroid therapy for bacterial keratitis. We do not have sufficient evidence to determine the effects of adjunct treatment with topical corticosteroids for bacterial keratitis.