Corneal Topographic Changes in Patients with Vernal Keratoconjunctivitis Before and After Supratarsal Triamcinolone Injection

Abstract

Background: Vernal keratoconjunctivitis is a very common bilateral inflammation of the cornea and conjunctiva that can lead to vision threatening problems such as shield ulcer and corneal opacity. Variable treatment modalities were tried such as topical and systemic anti-histaminics, topical steroids and mast cell stabilizers. Supratarsal injection of triamcinolone acetonide was proved to be a safe and effective method for treatment of vernal keratoconjunctivitis. Objective: To evaluate changes in corneal topography indices before and after supratarsal injection of triamcinolone acetonide in patients with vernal keratoconjunctivitis. Patients and methods: This study included 30 eyes of 15 patients with vernal keratoconjunctivitis who visited Al-Azhar University Hospitals and Alexandria Ophthalmology Hospital during in the period from June 2020 to December 2020. The patients were treated with supratarsal triamcinolone injection and corneal topography was done for them before and after injection. Patients were evaluated pre and postoperatively. This included history taking and full clinical examination. Follow up visits 1 day, 1 month and 4 months after injection to assess signs of recovery. Corneal topography with Sirius pentacam was done before injection, 2 months and 4 months after injection to assess corneal topographic changes. Results: There were statistically significant changes in the degree of astigmatism, corneal asphericity and surface asymmetry in some cases after injection. No statistically significant differences were recorded in K readings, corneal thickness or visual acuity. Conclusion: Vernal keratoconjunctivitis was proved to cause changes in corneal topography and lead to changes in visual acuity and patient's refraction. Supratarsal injection of triamcinolone acetonide was an effective way to treat cases of Vernal Keratoconjunctivitis (VKC), and decrease the topographic changes related to this disease.