Objective: To compare the safety and efficacy of loteprednol etabonate 0.5% (LE) and fluorometholone 0.1% (FM) in vernal keratoconjunctivitis (VKC) in pediatric subjects.

Material and Method: This study evaluated 64 children between 6-14 years old who received monotherapy with either LE 0.5% in one eye and FM 0.1% in fellow eye for the treatment of ocular inflammation associated with VKC. Throughout the one-month duration of the study, patients were called once a week, and ocular complaints (itching, watering, discharge, burning and photophobia) and symptoms (eyelid edema, limbal infiltration, papillary hypertrophy, Trantas dots and punctate keratopathy) were recorded during this period. McNemar test was used to make comparison of symptoms and sings between two groups. Wilcoxon test was used to assess the increase in intraocular pressure. Finally, patients were requested to select among the drugs they have been using and the obtained data were evaluated with binomial test.

Results: Improvement in watering, discharge, eyelid edema, limbal infiltration, papillary hypertrophy, and Trantas’ dots were noted in both groups (p=0.074). The symptoms in LE-treated eyes improved faster than FM-treated eyes (especially in terms of Trantas’ dots) (p=0.031). Mean intraocular pressure (IOP) increased in both treatment groups (p=0,001). The increase of IOP in FM-treated eyes started significantly earlier, and reached to a higher level than LE-treated eyes. (p=0.05, p=0.001) Also no correlation was observed between age and the increasement of IOP. (LE, p= 0.929; FM p=0.595). Visual acuity and dilated funduscopy results were similar between the treatment groups.

Conclusion: LE solution was an effective in the treatment of VKC in the pediatric group. No changes in IOP were observed in eyes treated with LE at each time point. Therefore it is preferable to treat VKC in childhood.

Loteprednol etabonate Pediatric Vernal keratoconjunctivitis Intraocular pressure