Treatment of Vernal Keratoconjunctivitis: Comparison between Topical Cyclosporine 0.05% and Fluorometholone 0.1% in Terms of Efficacy and Safety

Background: This study was undertaken to evaluate and compare the efficacy and safety of topical solutions of Cyclosporine and Fluorometholone in patients of vernal keratoconjunctivitis. Settings and design: This was a prospective, double blind, comparative, interventional randomized controlled trial, Material and methods: Patients of vernal kerato-conjunctivitis were included in the study after obtaining their informed consent.Each eye of one patient was prescribed either Cyclosporine eye drops or Fluorometholone eye drops. Patients’ vernal keratoconjunctivitis specific symptoms, signs and intraocular pressure were graded and measured repeatedly till 90th day. Statistical analysis used: The intra-group and inter-group changes in symptoms and signs during the course of study were compared using repeat measure ANOVA test. Results: Forty four subjects completed the study, with male preponderance. There was a progressive statistically significant reduction in the symptoms of itching, watering discharge and photophobia from day 7 till day 30 in both the groups.In Cyclosporine group there intra ocular pressure remained unaffected (P=0.17), but, in Fluorometholone group there was a significant increase in intra ocular pressure (P<0.0001). In the patients with mild disease, the improvement was similar in both the groups (P=0.486, Repeated measures ANOVA test). Conclusions: In mild cases of vernal keratoconjunctivitis, topical Cyclosporine is equally effective as topical Fluorometholone, and Cyclosporine is safer as there is no rise in intra ocular pressure.