From the Guidelines
Trifluridine eye drops are recommended as a 1% solution for viral eye infections, particularly herpes simplex keratitis, with a dosage of 1 drop onto the cornea of the affected eye five to eight times per day, as suggested by the most recent study 1. The treatment protocol for trifluridine eye drops typically involves administering the drops until the corneal ulcer heals, and then reducing the frequency to prevent potential corneal toxicity with prolonged use.
- Key considerations for trifluridine eye drops include:
- Dosage: 1% solution, five to eight times per day 1
- Treatment duration: until the corneal ulcer heals, with a maximum of 21 days to avoid corneal toxicity 1
- Administration: patients should tilt their head back, pull down the lower eyelid to form a pocket, look up, and place the drop in the pocket without touching the dropper to the eye or surrounding tissues
- Potential side effects: mild burning or stinging upon application, and patients should be advised to contact their doctor if they experience increased eye pain, redness, irritation, or no improvement after 7 days of treatment
- It is essential to note that trifluridine inevitably causes epithelial toxicity if used for more than 2 weeks, and topical ganciclovir is less toxic to the ocular surface 1.
- Patients should have a follow-up visit within 1 week of treatment, consisting of an interval history, visual acuity measurement, and slit-lamp biomicroscopy, as recommended by the most recent study 1.
From the Research
Recommended Dosage and Treatment Protocol
- The recommended dosage of trifluridine eye drops is 1% solution, with the frequency of administration varying depending on the study 2, 3.
- In one study, trifluridine 1% solution was effective in over 90% of patients with dendritic ulcers, with a high success rate and minimal side effects reported 2.
- Another study found that trifluridine administered 5 times a day was as effective as 1% cidofovir, and that treatment with cidofovir was as effective as that with trifluridine 3.
Comparison with Other Antiviral Agents
- Trifluridine has been compared to other antiviral agents, including idoxuridine, vidarabine, acyclovir, and ganciclovir, with varying results 4, 5, 6.
- One study found that trifluridine and acyclovir were more effective than idoxuridine or vidarabine, and similar in therapeutic effectiveness 4, 5.
- Another study found that trifluridine, acyclovir, and vidarabine were more effective than idoxuridine for the treatment of dendritic or geographic epithelial keratitis 6.
Treatment Outcomes
- The treatment outcomes for trifluridine eye drops have been evaluated in several studies, with varying results 2, 3, 4, 5, 6.
- One study found that trifluridine treatment was highly effective in a rabbit model, even when given only once a day 3.
- Another study found that trifluridine and acyclovir were more effective than idoxuridine or vidarabine, with a higher proportion of eyes healed at 14 days 4, 5.