Efficacy and safety of low-dose topical tacrolimus in vernal keratoconjunctivitis.
OBJECTIVE
The objective of this study was to evaluate the efficacy and safety of topical low-dose tacrolimus (0.01%) solution in patients with vernal keratoconjunctivitis (VKC).


METHODS
A total of 62 consecutive patients with VKC refractory to conventional treatment were included retrospectively. Tacrolimus 0.01% ophthalmic solution was administered to patients twice daily after discontinuation of all previous topical medications. The duration of treatment ranged from 1 month to 29 months. The clinical symptoms of itching, redness, foreign body sensation, and discharge and the clinical signs of conjunctival hyperemia, conjunctival papillary hypertrophy, limbal infiltration, Trantas dots, and superficial punctate keratopathy were graded as 0 (normal), 1+ (mild), 2+ (moderate), or 3+ (severe). Assessment was carried out before initiation of therapy and on the last visit after treatment.


RESULTS
There were 62 patients with VKC comprising 49 male and 13 female patients. The median age was 12 years (range: 5-47 years). The mean visual acuity improved from 20/30 to 20/25 following treatment. There was statistically significant improvement in symptoms of itching (P<0.001), redness (P<0.001), foreign body sensation (P<0.001), and discharge (P<0.001). Statistically significant improvement was also observed in clinical signs of conjunctival hyperemia (P<0.001), limbal infiltration (P<0.001), Trantas dots (P<0.001), superficial punctate keratopathy (P<0.001), and conjunctival papillary hypertrophy (P<0.001). The solution form of tacrolimus was well tolerated. None of the patients developed elevation of intraocular pressure, cataract, or infectious keratitis.


CONCLUSIONS
Low-dose topical tacrolimus 0.01% solution is effective and safe in the management of patients with refractory VKC.
The Eye Center and The Eye Foundation for Research in Ophthalmology, King Saud University, Riyadh, Saudi Arabia.
Samir S
SS
Shoughy
The Eye Center and The Eye Foundation for Research in Ophthalmology, King Saud University, Riyadh, Saudi Arabia.
Mahmoud O
MO
Jaroudi
The Eye Center and The Eye Foundation for Research in Ophthalmology, King Saud University, Riyadh, Saudi Arabia; Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Wilmer Ophthalmological Institute of the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Khalid F
KF
Tabbara
solution; tacrolimus; topical; vernal keratoconjunctivitis