The effect of supratarsal dexamethasone injection-topical cromolyn combination versus topical cromolyn in treatment of vernal Keratoconjunctivitis

This study aimed to assess the effect of supratarsal dexamethasone injection-topical cromolyn combination versus topical cromolyn in patients with vernal Keratoconjunctivitis (VKC) referred to Matini hospital during 2012-2013. This analytical study included 168 eyes of 84 patients with moderate to severe VKC. Patients were randomly divided into two groups. Both eyes of each patient in group1were assigned to receive cromolyn drop (every 6 hours for 3 weeks) and both eyes of each patient in group 2 were assigned to receive a 0.5 ml injection per eye of dexamethasone sodium phosphate in supratarsal area in addition to topical cromolyn. All of the patients were followed-up for 3 weeks after the treatment and evaluated for the removal of itching, epiphora and redness. Although the effect of the two treatment methods on subsiding of patient`s itching was not significantly different, the elimination of inflammation, redness and tearing in patients treated with cromolyn-dexametasone was significantly better than the other group (P<0.001). This study showed that the elimination of the signs and symptoms was more significant in patients with combination therapy compared to cromolyn (P<0.001). Moreover, 68.3% of the patients with combination therapy have eliminated itching and epiphora, and inflammation and redness were resolved in 88.1% of the patients, but in the cromolyn group, itching, redness and inflammation became worse or had no change in 50% of the patients. Combined supratarsal injection of dexamethasone and topical cromolyn is an appropriate treatment for the moderate and severe VKC.