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

Objectives: Vernal keratoconjunctivitis (VKC) is a severe ocular inflammatory disease that requires potent anti-inflammatory drugs as a reliever. Despite the unpopularity, tacrolimus could admirably control inflammations. However, studies regarding topical tacrolimus effectivity for VKC are still lacking.
Methods: We conducted a systematic review to evaluate the effect of topical tacrolimus on VKC. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist for this systematic review. Relevant articles were retrieved from Cochrane Library, PubMed, EBSCO Host, ProQuest, and Google Scholar databases. We specifically included publication in English. This study was registered with PROSPERO under the number CRD42022302291.
Results: A total of 11 studies were included, involving 607 participants with a mean age of 8.45 ± 4.0 years. Tacrolimus doses used as intervention ranged from 0.005% to 0.1%, available in eye ointment or eye drops. In general, topical tacrolimus reduced the total objective signs score (TOSS) as well as the total subjective symptoms score (TSSS). Application of topical tacrolimus was reported to have some adverse effects, such as a burning sensation, ocular stinging, pain, redness, and occasional photophobia.
Conclusions: The results of this systematic review suggest that topical tacrolimus could significantly reduce VKC signs and symptoms. Tacrolimus has good safety properties with minimal complications and side effects.