Abstract：
Vernal keratoconjunctivitis (VKC) is a chronic severe ocular allergic inflammation mostly observed in children and young adults. The ocular manifestations are the expression of multifactorial immune mechanisms that generally have a good prognosis, however long-term inflammation may remarkably reduce the visual function due to complications and poor therapeutic responses. Lack of responsiveness to a drug or treatment is relatively common in VKC and it is not only due to corneal involvement, which is considered the main sign of severity. The concept of refractory may be relative to multiple factors including the clinical condition, systemic co-morbidities, previous or concomitant drugs or regiments, compliance, patient\'s psychological condition or expectations, type of exposome and environmental conditions, doctor\'s experience and expectations, or timing of clinical evaluation. In this narrative review, the authors propose a definition of refractory VKC based on revised literature and clinical experience and consider potential new treatments for refractory patients and surgical management in case of complications.
摘要：
春季角膜结膜炎（VKC）是一种慢性严重的眼部过敏性炎症，主要在儿童和年轻人中观察到。眼部表现是多因素免疫机制的表达，通常具有良好的预后，然而，由于并发症和治疗反应不佳，长期炎症可能会显著降低视觉功能。对药物或治疗缺乏反应性在VKC中相对常见，这不仅是由于角膜受累，这被认为是严重程度的主要标志。难治的概念可能与多种因素有关，包括临床状况，系统性合并症，以前或伴随的药物或方案，合规,患者的心理状况或期望，暴露类型和环境条件，医生的经验和期望，或临床评估的时机。在这篇叙述性评论中，作者根据修订后的文献和临床经验提出了难治性VKC的定义,并考虑了难治性患者的潜在新疗法和并发症的外科治疗.
