Clinical study of role of topical tacrolimus 0.03% eye ointment in vernal keratoconjunctivitis
Dr. Amit Mohan, Dr. Jalpa Thakarani, Dr. Sudhir Singh and Dr. Vinod K Sharma
Background: Vernal keratoconjunctivitis (VKC) is recurrent bilateral allergic inflammation of conjunctiva and cornea. It is more prevalent in hot dry climate like Indian subcontinent. Antihistaminics and mast cell stabilizers are the first line treatment of VKC. In severe cases corticosteroids are used. But because of severe side effect of steroids immunomodulators have been used as substitutes for corticosteroids. The aim of this study is to determine the clinical efficacy of topical 0.03% tacrolimus as a sole therapy in VKC. Material and methods: 50 patients of VKC were selected & divided into two subgroup. Group A: In which 0.03% tacrolimus ointment was applied twice a day with tear drops as placebo. Group B: In which 0.1% olapatadine ophthalmic solution was applied twice a day along with 0.03% tacrolimus ointment. Each patient was examined on slit lamp and symptom and sign was graded on a scale from 0 to 3 before the introduction of therapy, on day 7, 30 and 90. The student’s T-test for independent sample was used to compare the results between two groups. Results: There is significant reduction in the signs (conjunctival hyperaemia, tarsal papillary reaction, punctuate epithelial keratitis, limbal gelatinous infilterate) and symptoms (itching, tearing, foreign body sensation, photophobia, discharge) in both the group on day 7, 30 and 90 days. (P<0.05) Conclusion: The isolated use of tacrolimus and the combined use of tacrolimus with olopatadine have similar efficacy in reducing clinical symptoms and signs in cases of VKC which are refractory to conventional therapy.