SUPRATARSAL INJECTION OF TRIAMCINOLONE ACETONIDE FOR THE TREATMENT OF SEVERE VERNAL KERATOCONJUNCTIVITIS

Abstract

Objective: To find out the use of supratarsal injection of triamcinolone acetonide in severe vernal keratoconjunctivitis in children.

Methodology: This descriptive study was conducted at Department of Ophthalmology, Hayatabad Medical Complex (HMC), Peshawar from 1^st May, 2015 to 30^th September, 2016. It included 62 eyes of 39 patients with severe vernal keratoconjunctivitis (VKC) associated with shield ulceration/keratitis, gelatinous limbal infiltrate and/or giant papillae on tarsal conjunctiva which showed resistance to conventional topical anti-allergic drops. Patients were treated with 20mg (0.5ml) supratarsal injection of triamcinolone acetonide. The patients were followed at 1^st, 2^nd and 4^th weeks and at 3^rd and 4^th months after injection. Data analysis were done using SPSS version 16.

Results: Our study included 62 eyes of 39 patients. Twenty two (56.41%) patients were male and 17(43.59%) were females. Mean age was 6.90 years (range 4.0-10 years). In all patients (100%), the disease was successfully controlled for an average of 3 months. Repeat injection was needed in 4 patients (10.26%) at one month post injection due to early recurrence of symptoms & signs. Only 9 (23.07%) patients required repeat injection after 3 months. We observed no intraoperative or postoperative complications like cataract and glaucoma.

Conclusion: Rapid and dramatic clinical response and lack of complications suggested that supratarsal injection of triamcinolone acetonide constitutes an effective and safe option for severe and challenging cases of vernal keratoconjunctivitis.