Prevention
Prophylaxis should commence on the day of the first dose of cytarabine and continue for at least 72 hours after the completion of the last cytarabine dose. Choose one of the following preparations:rrr
Dexamethasone 0.1% eye drops |
Instil ONE drop into each eye 4 to 6 times daily |
Fluorometholone 0.1% eye drops |
Instil ONE drop into each eye 4 to 6 times daily |
Prednisolone sodium phosphate 0.5% eye drops |
Instil ONE drop into each eye 4 to 6 times daily |
Note: Shake the eye drop bottle gently but thoroughly; dexamethasone and fluorometholone are contained in suspension.
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It is suggested that topical corticosteroid reduce epithelial toxicity through inhibition of epithelial cell division. As cytarabine inhibits DNA synthesis in the corneal epithelium, a reduction in DNA replication by the steroid drops means corneal epithelial cells are less susceptible to the effects of cytarabine.r
Sodium chloride 0.9% eye drops or artificial tears (TWO drops into each eye every 4 hours) have also been reported to be as effective as corticosteroid eye drops.r
The addition of a non-steroidal anti-inflammatory based eyedrop (such as diclofenac 0.1%) to the current treatment of steroid eyedrops has also been shown to prevent cytarabine-induced conjunctivitis but warrants further investigation.r