Clinical Ophthalmology (Jul 2021)
Is Interferon α-2b 1 MillionIU/mL Truly Better Than Tacrolimus 0.03% for Steroid-Resistant VKC ?: Our 2-Year Experience at a Tertiary Health-Care Centre
Abstract
Sukriti Gupta,1 Priyanka Singh,2 Mrityunjay Singh,1 Mayuresh Naik,3 Kartikeya Srivastava1 1Department of Ophthalmology, V.M.M.C & Safdarjung Hospital, New Delhi, 110029, India; 2Department of Ophthalmology, ESI Medical College and Hospital, Faridabad, Haryana, 121012, India; 3Department of Ophthalmology, H.I.M.S.R & H.A.H. Centenary Hospital, New Delhi, 110062, IndiaCorrespondence: Mayuresh NaikDepartment of Ophthalmology, H.I.M.S.R & H.A.H. Centenary Hospital, Room no. 3 of Eye OPD, 1st Floor of OPD Building, Near GK-2, Alaknanda, New Delhi, 110062, IndiaTel +91-8287344576Email [email protected]: To compare the efficacy of eye-drop interferon (IFN) α-2b 1 millionIU/mL with eye-ointment tacrolimus 0.03% in refractory vernal keratoconjunctivitis (VKC).Materials and Methods: Fifty patients with VKC refractory to conventional treatment with topical corticosteroids and antihistamines after 4 weeks of regular use were selected retrospectively. Patients were divided into two groups depending on whether they received eye-ointment tacrolimus 0.03% three times a day or eye-drop IFN alpha-2b 1 millionIU/mL three times a day and were followed up for 24 months. The main outcome measures were total subjective symptom score (TSSS) and total objective ocular score (TOSS).Results: Mean baseline TSSS was 7.24± 1.98 in Group A (tacrolimus group) and 7.84± 1.82 in Group B (IFN group), and it reduced to 1.12± 0.83 in Group A and 0.62± 0.41 in Group B at 6 months, which was statistically significant compared to the baseline score (p< 0.05) as well as between the two groups. Mean baseline TOSS was 6.72± 2.07 in Group A and 6.56± 2.04 in Group B, and it improved to 1 month onwards to 1.52± 0.87 in Group A and 1.0± 0.71 in Group B at 6 months, which was statistically significant compared to the baseline score (p< 0.05) as well as between the two groups. Side effects like stinging and burning sensations were seen in the tacrolimus group only.Conclusion: Our study suggests that while both eye-drop IFN α-2b 1 millionIU/mL and eye-ointment tacrolimus eye ointment 0.03% are both safe and effective steroid-sparing agents in steroid-resistant VKC. IFN α-2b results in greater improvement in subjective symptoms and objective signs, has fewer side effects in long term and is better tolerated as compared to tacrolimus.Keywords: refractory vernal keratoconjunctivitis, tacrolimus, interferon α-2b, VKC
