Efficacy of Tacrolimus 0.03% Ointment Vs. Olopatadine 0.2% Eye Drops in Vernal Keratoconjunctivitis: A Comparative Study

Background: Vernal keratoconjunctivitis (VKC) is a chronic, vision-threatening eye inflammation typically starting in early childhood and often resolving by puberty, though it can begin earlier and persist into adulthood. This study aimed to evaluate the efficacy and safety of Tacrolimus 0.03% ointment versus Olopatadine 0.2% eye drops in the management of VKC. Method: A cross-sectional study was conducted at the Department of Ophthalmology, Mardan Medical Complex, Mardan from June 2023 to August 2024, encompassing 288 patients with VKC, who were randomly assigned to receive either Tacrolimus 0.03% ointment (n=144) or Olopatadine 0.2% eye drops (n=144). Demographic data, symptom severity, side effects, and patient satisfaction were assessed. Data were analyzed using SPSS 26.0 with descriptive statistics, t-tests for continuous variables, chi-square for categorical variables, and significance set at P < 0.05. Results: In a study of 288 VKC patients (mean age 12.6 ± 3.5 years, 73.6% male) treated with Tacrolimus 0.03% ointment or Olopatadine 0.2% drops, Tacrolimus showed greater improvement in pruritus (75.3% vs. 58.3%), photophobia (75.6% vs. 61.0%), and lacrimation (66.7% vs. 51.4%) (P < 0.001), with more complete symptom relief (77.8% vs. 58.3%, P < 0.001) and shorter time to improvement (14.2 vs. 21.6 days, P < 0.001); adverse events were more common with Tacrolimus (63.9% vs. 20.8%, P < 0.001), including burning (33.3%), ocular pain (25.0%), and skin irritation (5.6%), though patient satisfaction was higher (76.4% vs. 59.7%, P = 0.002), confirming its superior efficacy. Conclusion: Tacrolimus 0.03% ointment exhibits more efficacy than Olopatadine 0.2% eye drops in the treatment of VKC, offering more rapid and significant symptom relief.