Efficacy of Topical Cyclosporine A in Phlyctenular Keratoconjunctivitis Associated with Severe Corneal Inflammation

Abstract

Abstract: : Purpose: To assess the efficacy of topical cyclosporine A (CsA) in children with phlyctenular keratoconjunctivitis associated with severe steroid-dependent corneal inflammation. Methods: Prospective study of 11 children with a mean age of 9 ± 5 years. All patients had been previously unsuccessfully treated with systemic antibiotics and topical corticosteroids. Treatment consisted of 2% CsA qid, combined with topical corticosteroids for the first week. Main outcome measures were : ocular symptoms, corneal and conjunctival inflammation, local and systemic adverse events, and cyclosporinemia and creatininemia. Results: Inflammation was always controlled within 14 days. Inflammation did not recur on CsA monotherapy, during a mean follow-up of 11 ± 6 months (5 to 27 months). Treatment was well tolerated in 10 cases, and had to be stopped in one case because of a generalized cutaneous eruption. Cyclosporinemia was temporarily detectable in one case (18 ng/mL). Conclusions: Topical CsA is effective and safe in phlyctenular keratoconjunctivitis associated with severe corneal inflammation.

Keywords: conjunctivitis • immunomodulation/immunoregulation • keratitis