Dr.Shakti Vanaar

Dr. REVATHI RAJARAMAN, Dr.ARJUN VELAYUDHAN NAIR

Abstract

Enrolled cases had recurrent exacerbation of vkc with ocular surface damage unresponsive to conventional therapy developing shield ulcers before or during the course.

Grade 2, 3 shield ulcers were treated with debridement and AMG transplant. Multiple supratarsal steroid injections and our non-commercial preparation of dexamethasone (0.04%) eye drops were used management of resistant elements (giant papillae, limbitis, grade 1 ulcer, diffuse epitheliopathy).

In our report , all grade 2 and 3 ulcers healed within 2 weeks after AMG overlay. Supratarsal steroids is an excellent targeted drug delivery method in steroid nonresponsive cases . Our steroid preparation was proved to be an effective alternative to commercial steroids without increasing IOP in steroid respondent cases. Immunosuppressants can aid in stopping progression in aggressive VKC.

Our multimodal approach merges current treatment guidelines and best practice recommendations for reducing symptoms in intractable cases.