Efficacy and Safety of Topical Tacrolimus for Vernal Keratoconjunctivitis: A Systematic Review

Objectives: Vernal keratoconjunctivitis (VKC) poses a significant challenge in ocular inflammation management, necessitating potent anti-inflammatory interventions. Despite its restricted utilization, tacrolimus has emerged as a promising agent in inflammation control. However, the specific efficacy of topical tacrolimus in VKC remains underexplored. Methods: A systematic review was conducted to evaluate the impact of topical tacrolimus on VKC, adhering meticulously to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies were meticulously retrieved from comprehensive databases including Cochrane Library, PubMed, EBSCO Host, ProQuest, and Google Scholar, with a focus on English-language publications. This systematic review protocol was prospectively registered with PROSPERO (CRD42022302291).
Results: The review encompassed 11 studies involving 607 participants, with an average age of 8.45 years. Tacrolimus concentrations utilized in the interventions spanned from 0.005% to 0.1%, delivered through eye ointment or drops. Across the studies, topical tacrolimus demonstrated significant reductions in both the total objective signs score and total subjective symptoms score. Adverse events reported encompassed sensory experiences such as burning sensation, ocular stinging, pain, redness, and sporadic photophobia.
Conclusion: This systematic review underscores the notable efficacy of topical tacrolimus in ameliorating the clinical manifestations and symptomatic burden associated with VKC. Furthermore, tacrolimus exhibited a favorable safety profile, with minor adverse effects reported infrequently.