[Preliminary report of surgical treatment of vernal keratoconjunctivitis with giant papillae].

OBJECTIVE

To evaluate the efficacy and safety of excision and cryotherapy combine with amniotic membrane transplantation (AMT) for the treatment of vernal keratoconjunctivitis (VKC) with giant papillae (GP).

METHODS

Eight patients (16 eyes) with VKC, characterized by GP on the upper tarsal conjunctiva, refractory to medical treatment, underwent excision and cryotherapy associated with AMT. The follow up period ranged 3-22 months.

RESULTS

Corneal shield ulcers and superficial punctuate keratitis healed during the first week after the surgery and did not recur. Fourteen eyes were symptom free and without GP one month after surgery. No ectropion, trichiasis and other complications were noted. The blood vessels of upper tarsal conjunctiva could not be seen clearly, a small amount of conjunctival scar was observed. Recurrence of GP was observed in 2 eyes, with reduced area and lessened irritation symptom as compared with preoperative status. Among them, one eye was treated by cyclosporine eyedrops with improvement. The other eye did not improve, and underwent secondary surgery (a cotton patch soaked in fluorouracil was applied on the upper eyelid after excision and cryotherapy). Nine months after the treatment, the patient had no symptoms and GP did not recur.

CONCLUSIONS

Excision and cryotherapy combine with AMT may be an effective and safe method for the treatment of refractory VKC with GP. But the candidates for surgical treatment should be chosen carefully.