| ObjectiveVernal keratoconjunctivitis is a serious allergic ocular surface disease caused by various factors,and seriously affects the physical and mental health of patients.At present,no drug has been found to be safe and effective for the treatment of vernal keratoconjunctivitis,and the concentration of tacrolimus used in the treatment varies.This article discusses the efficacy and safety of 0.1% tacrolimus combined with 0.1%olopatadine eye drops in the treatment of refractory vernal keratoconjunctivitis.MethodsThe research subjects were 34 patients with refractory vernal keratoconjunctivitis diagnosed in the ophthalmology clinic of our hospital from January 2018 to December 2019.They were divided into an observation group and a control group by random number table method,with 17 cases in each group(34eye).The control group was treated with 0.1% olopatadine eye drops.The observation group was given0.1% olopatadine combined with 0.1% tacrolimus eye drops.Each follow-up visit was conducted before treatment and after 2 weeks,4 weeks,and 12 weeks of treatment.Observe the changes in patients' ocular symptoms,objective signs,intraocular pressure and vision before and after treatment,and observe the adverse reactions after medication.Standards for evaluating the clinical efficacy of spring keratoconjunctivitis are divided into marked,effective,improved,and ineffective.Obvious effect: the total score of symptoms and signs is reduced by more than 90%,effective: the total score of symptoms and signs is reduced by 71% ? 90%,improvement: the total score of symptoms and signs is improved by 51% ? 70%,invalid: the total score of symptoms and signs The score improvement is less than 50%,and the efficiency=(number of effective cases + number of markedly effective cases)/ total number of cases.We used SPSS25.0 software for statistical analysis of the data,with p <0.05 as the difference from statistical significance.Results1.Of the 31 patients(62 eyes)who were finally included in the study,the male-to-female ratio was2.88.The average age of patients with VKC was 10.97 ±4.71 years old.During the follow-up period,there were 1 case in the observation group and 2 cases in the control group,which were excluded from the study.After 12 weeks of treatment,the clinical efficacy of the two groups was 87.50% in the observation group and 53.34% in the control group.2.The baseline values of the total symptom scores of the two groups were 14(13.25,15.00)and 14(13.00,15.00)respectively,and there was no significant difference between the two groups before treatment(p > 0.05).After 2 weeks of treatment,the total symptom scores of the observation group and the control group decreased to 7(6.00,7.00)and 9(8.00,10.00)respectively,and there was statistical significance between the two groups(p < 0.05).After 4 weeks of treatment,the total symptom scores of the observation group and the control group decreased to 3.5(2.00,5.00)and 6(4.00,6.00)respectively,and there was significant difference between the two groups(p < 0.05).After 12 weeks of treatment,the total symptom scores of the two groups decreased to 2(1.25,2.75)and 4(2.00,5.00)respectively,but there was no statistical significance between the two groups(p > 0.05).The baseline scores of physical signs in the observation group and the control group were 12(11.00,12.88)and 12.5(11.00,13.00)respectively,and there was no significant difference between the two groups(p > 0.05).After 2 weeks of treatment,the total scores of physical signs in the two groups were 7(6.00,8.00)and 8.5(8.00,10.00),respectively,and there was significant statistical significance between the two groups(p= 0.001).After 4 weeks of treatment,the total scores of physical signs in the two groups were 3(2.13,4.00)and 6(5.00,6.50),respectively,and there was significant statistical significance between the two groups(p < 0.001).After 12 weeks of follow-up,the total scores of physical signs in the two groups were 2(1.00,3.00)and 4(3.00,5.00),respectively,and there was also significant statistical significance between the two groups(p<0.001).Compared with those before treatment,the scores of symptoms and signs in the two groups decreased significantly after 2 weeks,4 weeks and 12 weeks of treatment(p < 0.05).3.Before treatment,the BCVA of the two groups were 0.606 ±0.245 and 0.620 ±0.238 respectively,and there was no significant difference between the two groups(p>0.05).After 12 weeks of treatment,the BCVA of the observation group and the control group were 0.719 ±0.201 and 0.637 ±0.225 respectively,the difference was not statistically significant(p>0.05).The BCVA of the patients in the observation grouphad significant statistical significance before and after 12 weeks of treatment(p<0.001).The BCVA of patients in the control group had statistical significance before and after 12 weeks of treatment(p<0.05).4.There was no significant change in intraocular pressure between the observation group and the control group before and during treatment.No cataract and elevated intraocular pressure were found.In the observation group,only 9.68% patients had transient eye burning sensation,3.23% patients had transient eye tingling sensation,and there were no other complications.Conclusion1.The ratio of male to female in vernal keratoconjunctivitis in this study was 2.88: 1,and the average age was about 11 years old.From the clinical efficacy observation,after 12 weeks of treatment,the effective rate of the observation group was 87.50%,and the effective rate of the control group was 53.34%.2.In each follow-up,the total score of symptoms and signs of the two groups of patients were improved compared with that before treatment,and the BCVA of both groups of patients was improved before and after treatment,but the observation group was significantly better than the control group.Only9.68% of the patients in the observation group experienced a transient burning sensation in the eye,and3.23% experienced a transient tingling sensation in the eye,with no other complications.3.This study confirmed that 0.1% tacrolimus combined with 0.1% olopatadine is effective in the treatment of refractory VKC.However,the efficacy and safety of tacrolimus still need a longer follow-up period and a larger sample to further confirm. |
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