Resection and Cryotherapy Combined with Amniotic Membrane Transplantation for the Treatment of Vernal Keratoconjunctivitis with Giant Papillae

To evaluate the efficacy and safety of resection and cryotherapy combined with amniotic membrane transplantation （AMT） for the treatment of vernal keratoconjunctivitis （VKC） with giant papillae （GP）. Eight patients （16 eyes involved） with VKC, characterized by GP on the upper tarsal conjunctiva, underwent resection and cryotherapy in combination with AMT. The follow-up lasted for 3-22 months. The results showed that corneal shield ulcers and superficial punctuate keratitis healed during the first week after surgery and did not recur. Fourteen eyes （87.5 %） were symptom-free l month after surgery, and no GE ectropion, trichiasis and other complications were noted, but the blood vessels of upper tarsal conjunctiva could not be clearly seen and a little conjunctival scar was observed. Recurrence of GP was observed in 2 eyes （12.5 %）, with the area being less and irritation milder as compared with those before the operation. Among the two eyes, one eye was treated by cyclosporine eyedrops with improvement, but the other eye showed no improvement after the treatment, and underwent a second surgery with a cotton patch soaked in fluorouracil applied onto the supratarsal area after resection and cryotherapy. Four months after the treatment the patient presented no symptoms and GP did not recur. It is concluded that the resection and cryotherapy combined with AMT is an effective and safe treatment for VKC with GP.

Serum Vitamin D Levels of Children with Vernal Keratoconjunctivitis and Normal in Kinshasa

Background: Data on the serum vitamin D3 levels of vernal keratoconjunctivitis (VKC) children are not known well in Central Africa. Children with vernal keratoconjunctivitis are less exposed to sunlight. There is no study that shows the breadth of the serum vitamin D3 levels of vernal keratoconjunctivitis children and normal in our setting. Purpose: This study aimed to compare the serum 25-hydroxy vitamin D [25(OH)D3] levels of children with and without VKC. Methods: An observational, case-control study was performed from September 2019 to February 2020 in the Ophthalmology Department and the Clinical Biology Department of the University Hospital of Kinshasa. The case group was recruited consecutively in the consultation while the control group was enrolled in the nearest Rehoboth school complex using a systematic sample method (k = 4) on the presence register. Both cases and controls underwent the routine ophthalmological examination of the anterior segment and serum vitamin D3 levels were measured in both cases and controls using Mindray Chimic-Luminescence (CL)-1200i. Data were entered in Microsoft Sheets and analyzed using SPSS version 20.0. The Mann-Whitney-U test (M-U), and the t-Student test were used respectively to compare the mean serum vitamin D3 levels in both cases and controls. The correlation of Spearman (rho) was used to determine the association between Body Mass Index and serum vitamin D3 levels in the case group. Results: A total of 75 children with VKC (mean age 7.8 ± 4.4 years) and 75 children without VKC non-atopic control group (mean age 7.9 ± 4.3 years) were enrolled in this study. The vitamin D3 deficiency was more frequent among the case group than in the control group (40% vs 8%, p = 0.0001). Vitamin D3 insufficiency was more frequent in the case group than in the control group (33.3% vs 18.6%, p = 0.04). The mean serum vitamin 25(OH)D3 levels were statistically lower in children with VKC compared to those without (25.5 ± 8.7 ng/ml and 44.3 ± 18.5 ng/ml, p = 0.0001). Time spent outdoors during daylight by children with VKC was statistically lower than children without VKC (1.59 ± 0.71 hours and 2.28 ± 1.08 hours, respectively) (p = 0.0001). Body Mass Index and serum vitamin D3 levels in VKC children showed a negative correlation statistically significant (Spearman, rho = -0.452, p = 0.0001). Conclusion: This study showed statistically values of serum vitamin D3 levels in VKC children lower than in children without VKC.

Effects of vernal and allergic conjunctivitis on severity of keratoconus

AIM: To demonstrate the effects of two different types of allergic conjunctivitis on severity of keratoconus (KC). ·METHODS: We retrospectively reviewed the medical records of 171 KC patients referred between June 2010 and June 2011. The KC patients were divided into 3 groups as KC (group A), KC with vernal keratoconjunctivitis (VKC) (group B) and KC with allergic conjunctivitis (AC) (group C). Main outcome measures were demographic and ocular clinical features including age at presentation, gender, spherical equivalent (SE), best spectacle corrected visual acuity (BCVA), mean keratometric measurement (Km), central corneal thickness (CCT), and intraocular pressure (IOP). Groups were compared in term of study variables. · RESULTS: The median age at presentation was significantly lower in group B (P 【0.001). According to the median SE (P =0.003), BCVA(P =0.022), Km(P 【0.001), CCT (P =0.015) and Amsler-Krumeich classification (P 【 0.001), KC was more severe in group B. There was no significant difference in terms of IOP and corrected IOP among the groups (P =0.44), however there were 4 patients who had increased corrected IOP developed after topical corticosteroid use in group B. The differences among the groups persisted even after controlling for age and gender. · CONCLUSION: Our findings demonstrated a more severe KC in VKC patients despite their younger age which suggests evaluation of VKC patients as a separate group in keratoconus disease.