Management of refractory vernal keratoconjunctivitis with supra tarsal triamcinolone injection: our results

Vernal keratoconjunctivitis [VKC] cases are sometimes resistant to conventional treatments. We aimed to assess the efficacy, safety and longevity of the effect of supratarsal injection of intermediate acting steroid triamcinolone acetonide in the management of recalcitrant vernal keratoconjunctivitis. A prospective study comprising of Forty five patients [90 eyes] with severe VKC, and resistant to conventional method of treatments were selected and underwent injection of 0.6 ml triamcinolone acetonide in supratarsal area [in conjunctival side of upper lid] and were followed up for 12 months. Dramatic relief of symptoms [burning, itching, lacrimation and photophobia, tenacious discharge] was seen in all patients, in first few days after the supratarsal injection. Size of the cobble stone papillary hypertrophy in tarsal conjunctiva, gelatinous thickening of conjunctiva at limbus decreased significantly in the first month, but never disappeared completely. The mean period of recurrence of symptoms was 156.6 days [range 13-359 days]. No complication was noticed during the follow up period. All patients tolerated the treatment well. Supra tarsal injection of triamcinolone acetonide is a cheap, effective and safe modality for temporary suppression of clinical signs and symptoms of eyes with recalcitrant vernal keratoconjunctivitis. Rapid and dramatic symptomatic and clinical response and lack of complications suggest that supratarsal injection of triamcinolone acetonide could be a therapeutic approach for refractory vernal keratoconjunctivitis

Intra ocular pressure measurement with Goldmann applanation tonometer without using fluorescein: our results

The purpose of this prospective, double blind study was to evaluate a modified technique of Goldmann applanation tonometry without the use of fluorescein and compare these results when Goldmann applanation tonometry was done with fluorescein in same patients. The intraocular pressure in 86 eyes of 43 patients was measured with and without fluorescein by Goldmann applanation tonometry. Goldmann applanation tonometry without fluorescein underestimated IOP levels by 1 mm Hg. The modified technique of Goldmann applanation tonometry without fluorescein reflects standard Goldmann tonometry with fluorescein after a correction factor of + 1 mm Hg

Safety and efficacy of supra- tarsal injection of triamcinolone in the management of refractory vernal keratoconjunctivitis

We aimed to assess the efficacy, safety and longevity of the effect of supratarsal injection of intermediate acting steroid triamcinolone acetonide in the management of recalcitrant vernal catarrh. In this prospective study 45 patients [90 eyes] with severe Vernal Keratoconjunctivitis [VKC], resistant to conventional method of treatments underwent injection of 0.6 ml triamcinolone acetonide in supratarsal area [in conjunctival side of upper lid]. The effects were monitored and cases were followed for 12 months. Dramatic relief of symptoms [burning, itching, lacrimation and photophobia, ropy discharge] was seen in all patients in first few days after the supratarsal injection. Size of the cobble stone papillary hypertrophy in tarsal conjunctiva and gelatinous thickening of conjunctiva at limbus decreased significantly in the first month but never disappeared completely. Mean period of recurrence of symptoms was 156.6 days [range13-359 days]. All patients tolerated the treatment well and no complication was noticed. Rapid and dramatic symptomatic and clinical response and lack of complications shows that supratarsal injection of triamcinolone acetonide is safe and effective therapeutic approach for refractory VKC

Safety, efficacy and success with supero-temporal free conjunctivo-limbal autograft in the surgical management of pterygium: Our technique and results

The objective was to study the safety, efficacy and success with supero-temporal free conjunctivo-limbal autograft transplantation in the surgical management of pterygium. Prospective case series where superotemporal free conjunctivo-limbal auto grafting was performed on 24 eyes of 24 patients with vascular progressive pterygium. Pterygium recurrence was considered a surgical failure. Recurrence was defined as fibrovascular tissue crossing the corneoscleral limbus on to the clear cornea in the area of previous pterygium excision. recurrence of pterygium was noted in one out of 24 eyes [4.16%], after a minimum follow up of 6 months to maximum of 25 months [mean 14.6 months]. No major intraoperative or postoperative complications were encountered. In conclusion, superotemporal free conjunctivo-limbal autograft appears to be a safe and effective technique in the surgical management pterygium. The inclusion of limbal tissue in the conjunctival autograft following pterygium excision appears to be essential to ensure low recurrence rate