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Safety and Efficacy of Supra-tarsal Injection of triamcinolone acetonide in the management of severe/refractory vernal keratoconjunctivitis in children : Experience of the Ophtalmology A department at the Rabat specialty hospital (28 cases)

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First Author: K.Rifai MOROCCO

Co Author(s):    S. Moutamanni   o. cherkaoui                 

Abstract Details

Purpose:

To describe the importance of supra-tarsal injection of triamcinolone acetonide in the management of severe/refractory vernal keratoconjunctivitis in children.

Setting:

Vernal keratoconjunctivitis (VKC),is an allergic and inflammatory disease of the ocular surface.It primarily affects children during the first decade of their life and is complex to treat.The aim of this study is to evaluate the effectiveness of supra-tarsal injection of triamcinolone acetonide(TA) in the treatment of severe forms of VKC.

Methods:

This 18-month prospective study included 28 patients with severe/refractory form of VKC.A supra-tarsal injection of 1mL of TA 40mg was performed on the most affected eyes.In this study,we included all patients over three years old with a severe form of VKC with severe eyelid,limbic and/or corneal involvement. Patients under three,those with an active complication and those with a contraindication to corticosteroids were excluded.Each patient had a complete ophthalmologic examination and received adequate symptomatic treatment.The efficacy criteria were clinical, listed on a rating scale purposely designed based on literature data.Statistical analysis was performed with a comparison of means on paired series.

Results:

The analysis included 38 injections in 33 eyes of 28 patients with VKC.The average age was 10.3 years.The follow-up time was 19.3 months.Within the 28 patients,the disease was successfully controlled for an average of 3.6 months,during which the symptoms and functional signs were significantly attenuated.The mean period of symptom recurrence was 156.6 days.No complications were reported. Triamcinolone is a glucocorticosteroid used for its anti-inflammatory power.Its therapeutic efficacy was judged on the clinical cure rates obtained with 1ml;the complications and recurrences.Our results are identical to other studies,concluding that TA alone is highly effective in the treatment of severe forms of VKC.

Conclusions:

Treatment of severe VKC by injection of supra-tarsal AT has shown satisfactory results and has been well tolerated by patients, suggesting that this treatment may be an effective and safe alternative for these severe and refractory cases.

Financial Disclosure:

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