Supratarsal injections versus topical steroids in resistant vernal keratoconjunctivitis

Purpose The aim of this study was to compare the safety and efficacy of supratarsal triamcinolone acetonide injection versus supratarsal dexamethasone sodium phosphate injection versus topical prednisolone acetate 1% eye drops in the treatment of resistant cases of vernal keratoconjunctivitis (VKC). Patients and methods This is a comparative, prospective randomized study that was done on 120 eyes (60 patients) having resistant VKC. The eyes included in the study were divided into three groups. Group 1 included 40 eyes (20 patients) that received supratarsal injection of 20 mg of triamcinolone acetonide; group 2 included 40 eyes (20 patients) that received supratarsal injection of 2 mg of dexamethasone sodium phosphate; and group 3 included 40 eyes (20 patients) that received topical prednisolone acetate 1% eye drops. Results Supratarsal steroid injections provided more effective resolution of symptoms and signs in comparison to topical steroid eye drops. No statistically significant difference was found between triamcinolone acetonide and dexamethasone sodium phosphate supratarsal injections (P>0.05). However, the supratarsal injections showed a statistically significant higher resolution of symptoms and signs than those of topical steroids. Eyes in groups 1 and 2 (supratarsal injections) had a lower recurrence rate and a delayed recurrence in comparison to group 3 (topical steroid eye drops) (P<0.05). No complications related to the drugs or to the technique of injection were reported in all groups. Conclusion Supratarsal injection of steroids is an effective, easy, well-tolerated, and safe technique in the treatment of resistant VKC, which provides an effective and longer relief of symptoms and signs with a delayed and lower rate of recurrence.