Comparative Evaluation of Tacrolimus Versus Interferon Alpha-2b Eye Drops in the Treatment of Vernal Keratoconjunctivitis: A Randomized, Double-Masked Study.

PURPOSE: Vernal keratoconjunctivitis (VKC) is a bilateral, chronic, external ocular inflammatory disorder that mainly affects patients in their first or second decade. This study was designed to compare tacrolimus and interferon alpha-2b (IFN alpha-2b) eye drops in the treatment of VKC. METHODS: In this randomized, double-masked clinical trial, 40 consecutive patients with VKC were sent to a referral eye hospital in a tropical region southeast of Iran. Patients were randomly assigned to receive either 0.005% tacrolimus or IFN alpha-2b (1,000,000 units/cc). Chi-square and t tests were used for comparison of outcomes between both groups. RESULTS: Mean ± SD age was 11.1 ± 5.2 years. Thirty-one patients (77.5%) were male. The mean duration of disease was 3.4 ± 2.9 years. In this study, the signs and symptoms were significantly reduced in patients after treatment in both groups (P = 0.0001). In the tacrolimus group, all patients responded to treatment whereas only one subject in the IFN group failed to respond (P = 0.99). Side effects in both groups were mild and tolerable. CONCLUSIONS: This study indicated that both 0.005% tacrolimus and IFN alpha-2b are effective and appear to be safe in treatment of recalcitrant VKC.

Intravitreal autologous plasmin prepared by urokinase for vitreolysis: a pilot study.

PURPOSE: To evaluate the effects of intravitreal autologous plasmin injection (IVAP) on vitreoretinal diseases and vitreolysis. METHODS: In this interventional, prospective, case series pilot study, 8 eyes were assigned to IVAP. Plasminogen as centrifuged from the patients' plasma was converted to plasmin by adding urokinase. A total of 0.2 mL extracted plasmin was injected intravitreally. Posterior vitreous detachment (PVD) and potential injection-related complications at week 4 were the primary outcome measures. Secondary outcomes included changes in best-corrected visual acuity (VA) (logMAR) and central macular thickness (CMT). RESULTS: Mean age of the patients was 54.35 years. Two patients had complete PVD and 3 patients had partial PVD. Four patients had decrease in CMT. The VA was not changed in 6 patients, improved in 1 patient, and decreased in 1 patient. No uveitis, endophthalmitis, or postinjection vitreous hemorrhage was observed. CONCLUSIONS: This pilot study demonstrated the efficacy of urokinase-prepared IVAP injection on releasing vitreomacular traction and inducing vitreolysis.