Supratarsal Steroid Injection in Vernal Keratoconjunctivitis

BULL EGYPTIAN OPHTHALMOL SOC, 2000; 93, NUMBER 1

Supratarsal Steroid Injection in Vernal Keratoconjunctivitis.

Ahmed Shama, MD; Alaa Ghaith, MD.

Ophthalmology Dept. Alexandria University.

Abstract

Purpose: Purpose: To study the efficacy and safety of supratarsal injection of either short acting or intermediate acting steroids in the treatment of cases of refractory vernal keratoconjunctivitis (VKC).

Subjects and Methods: Subjects and Methods: 60 eyes of 30 patients with refractory VKC were divided into 2 equal groups receiving either short acting or intermediate acting steroids. A control group of 20 eyes of 10 patients received topical corticosteroids. Patients were evaluated for subjective relief of symptoms as well as improvement of clinical signs in the first, third and sixth month post-treatment. Complications were reported in a follow-up period of at least 6 months (range of 6-12 month).

Results: Results: A significant improvement in clinical signs was detected in the injection groups more than the control group within 2 weeks. 73.3 & 80% of cases did not need supportive treatment for at least 3 months in the 2 groups respectively. By the end of follow-up period, the disappearance of the large papillae was significant in both injection groups than the control groups, Z = -4.8571, P = 0.000. Re-injection was done after 3 months in 2 cases in the first group and 1 case in the second group because the parents preferred it to topical treatment. Intraocular pressure rise occurred in 1 case in the second group and 1 case in the control group that necessitated topical treatment for 1 month. Improvement of shield ulcers was dramatic in the injection groups (5 eyes) than the control group (2 eyes). No ptosis or hypopigmentation of the skin were reported in the injection group.

Conclusion: Supratarsal injection of steroids is a relatively safe procedure that dramatically improves cases of refractory VKC better than topical steroids. Short acting steroids gave relief of symptoms for shorter intervals. However, short acting steriods may be considered to decrease the risk of intraocular pressure rise. Supratarsal injection of steroids is a relatively safe procedure that dramatically improves cases of refractory VKC better than topical steroids. Short acting steroids gave relief of symptoms for shorter intervals. However, short acting steriods may be considered to decrease the risk of intraocular pressure rise.