Evaluation of tacrolimus and cyclosporine in the treatment of vernal keratoconjunctivitis in children

Abstract

Aims: To compare the efficacy and safety of 0.03% tacrolimus eye ointment with 2% cyclosporine eye drops in the treatment of vernal keratoconjunctivitis. Settings and Design: Comparative, Hospital-based, Prospective, Randomized, Clinical study. Methods and Material: About 56 children diagnosed with Vernal keratoconjunctivitis (VKC) were enrolled in the study. All the subjects underwent a comprehensive ophthalmic evaluation. Total subjective symptom scoring (TSSS) and Total objective sign scoring (TOSS) were done for each patient based on their history and clinical examination. They were divided into two groups. One group was treated with 0.03% tacrolimus ointment bd and the other with 2% cyclosporine eye drops tid. Both groups were also put on carboxymethylcellulose eye drops four times a day. Steroids were never used during the study. The patients were followed up at intervals of two weeks, four weeks, and eight weeks. At each follow-up, the TSSS and TOSS were done for each patient. Patients were also questioned about any adverse effects encountered by them during the treatment. A comparison was done between both groups based on the above scoring. Results: There was progressive reduction which was statistically significant (P < 0.05) in the TSSS and TOSS in both the groups throughout treatment. Reduction in TSSS The only adverse effect reported by a few patients was a burning sensation that was not severe enough to discontinue treatment. Conclusions: Both tacrolimus 0.03% eye ointment and cyclosporine 2% eye drops are effective in the treatment of VKC without any significant severe side effects. Tacrolimus eye ointment was more effective than cyclosporine drops.