[Treatment with cyclosporin A, with low doses, in high-risk penetrating keratoplasties. A bi-centric study of 90 cases].
OBJECTIVE
Evaluation of cyclosporin-A in prevention of immune reaction in high-risk penetrating keratoplasties.


METHODS
Cyclosporin A was given to 45 corneal allograft recipients, 5 mg/kg/j (cyclosporinemy between 100 and 150 ng/l), for three months following surgery. 45 controls have undergone penetrating keratoplasty during the same period. Mean follow-up was respectively 431 days and 402 days. Survival was analysed according to Kaplan-Meier's method, and then using Cox model.


RESULTS
The significant predictive factors were the number of neovascularized quadrants, and the graft diameter. No significant effect of cyclosporin is evidenced. Side effects are marginal.


CONCLUSIONS
Three hypothesis may explain the absence of prognosis improvement in the Cyclosporin A treated group: insufficient dose or duration of treatment, individual risk factors that prevents correct pairing, or corneal-specific immunological mechanisms.
Robert
P Y
PY
Service d'Ophtalmologie, C.H.U. Dupuytren, Limoges.
Delbosc
B
B
Preux
P M
PM
Monnot
P H
PH
Drouet
M
M
Peyronnet
P
P
Adenis
J P
JP
D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011292:Premedication; D012307:Risk Factors
D007166:Immunosuppressive Agents; D016572:Cyclosporine
Traitement par ciclosporine A, à doses faibles, dans les kératoplasties transfixiantes à haut risque. Etude bicentrique de 90 cas.