AIM: To assess the efficiency and reliability safety of ganciclovir to herpes simplex virus keratitis.

METHODS: All of the randomized controlled trials for the study of ganciclovir versus acyclovir in the treatment of herpes simplex virus keratitis were collected from Cochrane Library, EMbase, PubMed, Chinese Bio-medicine Database, China Journal Full-text Database, VIP Database and WanFang Database. Then the data were extracted and evaluated by two reviewers independently. Risk of bias assessment was evaluated by a tool recommended by Cochrane Library. Revman 5.0 software was used for statistical analysis.

RESULTS: Finally, 14 randomized controlled trials were included, 4 820 patients totally. Subgroups were used according to the number of patients and diseased eyes as well as the difference of follow-up time. For and relapse rate, ganciclovir group was overmatch acyclovir group. There were statistical differences between the two groups \〖RR=1.22, 95%CI(1.10-1.36); OR=4.50, 95%CI(2.02-10.04); RR=0.23, 95%CI(0.10-0.52)\〗. Compared with acyclovir, ganciclovir had less side-effect. There were statistical differences between the two groups \〖RR=0.12, 95%CI(0.03-0.46)\〗. All of the side effects of the two groups can be relieved by themselves.

CONCLUSION: Current evidence suggests that the ganciclovir is more efficient and safe than acyclovir in the treatment of herpes simplex virus keratitis.