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

Purpose: 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.

Vernal Keratoconjunctivitis: A Systematic Review

“…With the treatment, there was a statistically significant reduction in IOP ( p < 0.00001) High Jongvanitpak et al [ 83 ] 2020 Thailand 20 7.9 To describe outcomes of treatment in children with ocular allergy 68.8% of VKC patients used topical steroids to control the disease. Subcutaneous immunotherapy was performed in 2 patients after using tacrolimus eye ointment with benefits High Caputo et al [ 144 ] 2021 Italy 431 8.5 To evaluate the safety and efficacy of tacrolimus 0.1% eye drops in refractory VKC All the clinical signs significantly improved during the whole follow-up in both the perennial and seasonal forms High Elubous et al [ 145 ] 2021 Jordan 20 31.2 To identify environmental risk factors associated with the need for penetrating keratoplasty (PKP) in patients with keratoconus VKC is a statistically significant risk factor ( p = 0.005) for PKP High Feizi et al [ 146 ] 2021 Iran 117 25.4 To compare outcomes after penetrating keratoplasty (PK) against deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with VKC There is no difference in outcomes between PK and DALK for keratoconus in patients with VKC High Gupta et al [ 147 ] 2021 India 50 8.3 To compare the efficacy of eye drop interferon (IFN) α-2b with tacrolimus 0.03% in refractory 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 High …”

Is there an alternative therapy for refractory vernal keratoconjunctivitis? ‎

“…Interferon alpha-2b (IFN-∝2b) is an immunomodulatory cytokine, whose topical drops are effective agents to manage ocular surface conditions like VKC and pterygium [9]. TAC in many and IFN-∝2b is limited investigations have been successful agents in the management of such cases [10]. In one comparative study 2-immunomodulatory agents, TAC and IFN-∝2b compared in the treatment of VKC that had an equal effect in that are therapeutic effects, these two recently introduced medications may effectively control the VKC based on immunosuppressive strategies [11].…”