Abstract

Objective: We aimed to assess the efficacy, safety and longevity of the effect of supratarsal injection of intermediate acting steroid triamcinolone acetonide in the management of recalcitrant vernal catarrh.
Patients and Methods: In this prospective study 45 patients (90 eyes) with severe Vernal Keratoconjunctivitis (VKC), resistant to conventional method of treatments underwent injection of 0.6 ml triamcinolone acetonide in supratarsal area (in conjunctival side of upper lid). The effects were monitored and cases were followed for 12 months.
Results: Dramatic relief of symptoms (burning, itching, lacrimation and photophobia, ropy discharge) was seen in all patients in first few days after the supratarsal injection. Size of the cobble stone papillary hypertrophy in tarsal conjunctiva and gelatinous thickening of conjunctiva at limbus decreased significantly in the first month but never disappeared completely. Mean period of recurrence of symptoms was 156.6 days [range13-359 days]. All patients tolerated the treatment well and no complication was noticed.
Conclusion: Rapid and dramatic symptomatic and clinical response and lack of complications shows that supratarsal injection of triamcinolone acetonide is safe and effective therapeutic approach for refractory VKC. (Rawal Med J 2008;2008:235-238).

Key words: Vernal Keratoconjunctivitis [VKC]; triamcinolone acetonide; tarsal conjunctiva.