**7.1 Steroids for Corneal Ulcers Trial (SCUT)**

The large, randomized, placebo-controlled, double-masked multicenter clinical trial that compared 12 months clinical outcomes in patients receiving adjunctive topical 1.0% prednisolone sodium phosphate or topical placebo in the treatment of bacterial keratitis found that adjunctive topical corticosteroid therapy may improve best spectacle-corrected visual acuity (BSCVA) in bacterial corneal keratitis

not caused by Nocardia species. But no significant difference was identified by treatment for scar size for non-Nocardia ulcers. However, scar size was larger in Nocardia keratitis [96, 97].

## **7.2 Mycotic Ulcer Treatment Trial (MUTT) I**

The double-masked, multicenter trial that compare topical 5% natamycin vs. 1% voriconazole in the treatment of filamentous fungal keratitis showed a benefit of topical natamycin over topical voriconazole for filamentous fungal keratitis, particularly among those caused by Fusarium. Natamycin-treated cases had significantly better 3-month BSCVA, less likely to have perforation or require therapeutic penetrating keratoplasty than voriconazole-treated cases [74].

## **7.3 Mycotic Ulcer Treatment Trial (MUTT) II**

The randomized, placebo-controlled, double-masked multicenter clinical trial showed that adding oral voriconazole to topical antifungal agents in the treatment of severe filamentous fungal keratitis did not improve the rate of corneal perforation, the need for therapeutic penetrating keratoplasty (TPK), microbiologic cure at 6 days, rate of re-epithelialization, BSCVA, and infiltrate and/or scar size. However, oral voriconazole did increase in nonserious adverse events and cost [98].

### **7.4 The Herpetic Eye Disease Study (HEDS) I**

The Herpetic Eye Disease Study (HEDS) was a series of randomized, doublemasked, placebo-controlled clinical trials that studied ocular HSV and is still the gold standard for ocular HSV management [86]. HEDS showed a significant benefit of topical corticosteroids and oral acyclovir for HSV stromal keratitis [84, 99].

#### **7.5 The Herpetic Eye Disease Study (HEDS) II**

HEDS II showed that oral acyclovir decreased the recurrence rate of any type of HSV keratitis by 50% approximately [88, 100].
