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Mitra Akbari

Abstract

We describe a case of severed and steroid-resistant limbal vernal keratoconjunctivitis (VKC) with deficient limbal stem cells, limbal papillary hypertrophies, and its pattern of management with topical eye drops of tacrolimus (TAC) and interferon alpha-2b (IFN-∝ 2b). The present study is a case report and review of the literature. A woman aged 20 years with a complaint of decreased vision, ocular surface burning, and photophobia in both eyes since childhood age was referred to our cornea clinic. According to corneal impression cytology and incisional biopsy of the limbal hypertrophic lesions, the limbal VKC with deficient limbal stem cells had been diagnosed. She was resistant to topical steroid therapy, therefore topical tacrolimus 0.05% since 4 years ago improved her signs and symptoms, but the tacrolimus eye drop was not available many times and we have to replace it with topical IFN-∝ 2b eye drop and eventually the good visual acuity achieved with penetrating keratoplasty (PKP) and amniotic membrane transplantation (AMT) surgeries. In a severed and refractory VKC, topical tacrolimus can be replaced by IFN-∝ 2b and enhanced remission that can resolve patient’s complaints and graft survival in such complex cases‎.

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