Control de la exacerbación inmunohistológica de la queratoconjuntivitis vernal con pomada de tacrólimus

Resum

Vernal keratoconjunctivitis involves a large number of ocular complications; it is capable to cause a diverse numbers of alterations in young patients. In many cases, it is necessary to apply corticosteroid therapy, although the side effects leaded to their use, therefore the importance of finding alternative treatments to it as topical immunosuppressants where tacrolimus emerges as a new therapeutic option. The aim of this study was to evaluate the therapeutic effects of tacrolimus in patients with vernal keratoconjunctivitis. For this retrospective study, we chose four patients diagnosed with vernal keratoconjunctivitis, under than 7 years, in whom topical tacrolimus was applied at the Department of Ophthalmology of the University Hospital San Cecilio. The severity of the disease in these cases and the effectiveness of tacrolimus were evaluated using a novel scoring system named 5-5-5. The patients received previous treatment with antihistamines and / or topical corticosteroids for a median of two years with no clinical outcome. After three months of treatment with tacrolimus, significant clinical outcome was achieved, evolving from an initial state of moderate vernal keratoconjunctivitis to a mild state with no side effects associated. Therefore the use of tacrolimus ointment is a safe and effective treatment for patients with vernal keratoconjunctivitis refractory to conventional treatment.