DR. DEEPALI SINGHAL

Dr.PRAFULLA KUMAR MAHARANA, DR. NIMMY RAJ

Abstract

We describe the role of combined topical cyclosporine and tacrolimus in severe steroid intolerant vernal keratoconjunctivitis. Medical records of 11 patients (22 eyes) with acute steroid intolerant VKC were reviewed from March 2017 to December 2018. All were started on topical CsA 0.1% QID. Due to suboptimal response at 2 weeks, topical tacrolimus 0.03% BD was added. The mean total subjective score at presentation was 13 ± 1.4, reduced to 11.2 ± 1.3 at 2 weeks of topical CsA therapy and further reduced to 5 ± 0 at 2 weeks of combination therapy (p < 0.001). The mean total objective score at presentation was 9.4 ± 1.4, reduced to 8.0 ± 1.3 at 2 weeks of topical CsA therapy and further reduced to 4.3 ± 1.6 at 2 weeks of combination therapy (p < 0.001). The absolute change in the total subjective and objective score was much more with combination therapy. Thus, combined use of cyclosporine and tacrolimus may lead to rapid resolution of symptoms in cases with severe steroid intolerant VKC