A Comparative Study of Efficacy of 0.03% Tacrolimus Eye Ointment and 0.05% Cyclosporin Eye Drops in the Treatment of Vernal Keratoconjunctivitis

Abstract

Background: Vernal keratoconjunctivitis (VKC) is a chronic, immune-mediated ocular surface disease leading to significant discomfort and potential visual impairment, traditionally managed with steroids that carry substantial side effects. Immunomodulatory therapies such as topical tacrolimus and cyclosporin offer steroid-sparing alternatives, but limited local data exists comparing their efficacy in Pakistani populations. Objective: To compare the efficacy of 0.03% tacrolimus eye ointment and 0.05% cyclosporin eye drops in reducing total subjective symptom score (TSSS) and total objective sign score (TOSS) in patients with VKC over a 12-week period. Methods: In this randomized controlled trial conducted at Benazir Bhutto Hospital Rawalpindi, 220 patients aged 5–18 years with VKC were randomly assigned to receive either 0.03% tacrolimus ointment twice daily or 0.05% cyclosporin drops four times daily. TSSS and TOSS were recorded at baseline, 4 weeks, and 12 weeks. Data were analyzed using paired and independent t-tests, with p ≤ 0.05 considered significant. Results: Both groups showed significant reductions in TSSS and TOSS from baseline to 12 weeks (p < 0.0001). No statistically significant differences were observed between groups at any time point, although tacrolimus showed slightly lower mean scores at 12 weeks. Conclusion: Both treatments effectively reduced VKC symptoms and signs, supporting their role as safe, steroid-sparing therapies, with tacrolimus offering marginally greater symptom relief. Further studies are recommended to establish standardized treatment guidelines.