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A comparative study between ciclosporine A eye drop (2%) and tacrolimus eye ointment (0.03%) in management of children with refractory vernal keratoconjunctivitis

  • Pediatrics
  • Published:
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Abstract

Purpose

To compare the effects of ciclosporine A (2%) eye drop and tacrolimus (0.03%) eye ointment on children with vernal keratoconjunctivitis (VKC) who were not responding to corticosteroid eye drops.

Methods

A prospective comparative study was carried out on children who were diagnosed with refractory VKC at the ophthalmology clinic in Benha University, Delta area, Egypt, during the period from October 2019 to February 2020.

Results

Fifty-nine patients completed this study. Regarding the individual symptom score, redness, burning, photophobia, and foreign body sensation were significantly reduced in the tacrolimus group compared to those in the ciclosporine A group during the 1st week (p < 0.05). Moreover, the tacrolimus group showed a statistically significant reduction in burning and foreign body sensation at the 4th week (both p = 0.032), and in redness and burning sensation at the 12th week compared to those in the ciclosporine A group (p = 0.005 and 0.048, respectively). The tacrolimus group showed significantly lower mean scores for tarsal conjunctival papillary hypertrophy at the 1st week and 12th week (p = 0.037 and 0.046, respectively), and for punctate erosion and cobblestone papillae at the 1st week (p = 0.029 and 0.037, respectively) than the ciclosporine group. Failure of treatment was observed in 6 patients (19.35%) in the ciclosporine A group and in 5 patients (17.85%) in the tacrolimus group. No serious side effects were detected in any group.

Conclusion

A higher reduction in inflammatory symptoms and signs as well as compliance with tacrolimus 0.03% eye ointment than with ciclosporine A 2% eye drops was observed. Moreover, long-term medication for refractory cases is needed to control inflammation. Overall, our finding suggested that ciclosporine A eye drops and tacrolimus eye ointment could be considered as corticosteroid-sparing drugs in the management of children with refractory VKC.

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Data availability

The data of patients used to support the findings of this study are restricted by the Benha University Hospital Research Ethics Board. Data are available for researchers who meet the criteria for access to confidential data upon request from Assistant Professor Mohamed Amin Heikal, Department of Ophthalmology, Benha University, Egypt. E-mail: mohammedheikel@gmail.com.

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Funding

No funds, grants, or other support was received.

The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Ophthalmology Department, Benha University, Benha, Egypt

    Mohamed Amin Heikal, Tarek T. Soliman, Walid Samir Abousaif & Ahmed Adel Shebl

  2. Magrabi Eye Hospital, Eastern Province, Khober City , Kingdom of Saudi Arabia

    Mohamed Amin Heikal

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  1. Mohamed Amin Heikal
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  2. Tarek T. Soliman
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  3. Walid Samir Abousaif
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  4. Ahmed Adel Shebl
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Correspondence to Mohamed Amin Heikal.

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Ethics approval

The Institutional Review Board (IRB) and Research Ethics Committee of Ophthalmic Department, Benha University, approved the study)5/2019). The study adhered strictly to the tenets of the Declaration of Helsinki (2013 revision).

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All subjects (patients and their parents) provided informed written consent for participation.

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Heikal, M.A., Soliman, T.T., Abousaif, W.S. et al. A comparative study between ciclosporine A eye drop (2%) and tacrolimus eye ointment (0.03%) in management of children with refractory vernal keratoconjunctivitis. Graefes Arch Clin Exp Ophthalmol 260, 353–361 (2022). https://doi.org/10.1007/s00417-021-05356-0

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  • DOI: https://doi.org/10.1007/s00417-021-05356-0

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