[Intracorneal depot steroids for the treatment of corneal rejection after keratoplasty].
OBJECTIVE
To introduce a new type of therapy for corneal rejection after keratoplasty with the microinjection of intrastromal depot cortisone in single or multiple doses.


METHODS
Thirty-three consecutive eyes with corneal graft rejection were diagnosed and treated by one of the authors (EA) between January 1998 and November 2000.


RESULTS
Of the 33 eyes, 26 were submitted to Penetrating Keratoplasty (PK), five to lamellar, and two to homoplastic keratoplasty. The most common rejection type was epithelial in 20 eyes, 11 eyes showed mixed rejection types and two eyes, endothelial. In 18 of the cases (54.54%) treatment consisted solely of intraestromal injection; in the other 15 cases some other medications were added mostly because of patient anxiety. The vast majority of the cases (81%) improved clinically within a few days after the injection. Fifty-four percent of the cases required a number of doses ranging from one to five; the rest of the cases had a greater number of sessions. Thirty-one cases have been followed up for a period longer than six months without showing increase in intraocular pressure or development of steroid lens opacities.


CONCLUSIONS
Intrastromal depot cortisone injection is a new alternative for the treatment of corneal graft rejections after keratoplasty.
Department of Surgery, National University, Fundación Santa Fe de Bogota, Columbia. earenas@cable.net.co
E
E
Arenas
M
M
Navarro
M A
MA
Mieth
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001623:Betamethasone / Q000008:administration & dosage*; D002648:Child; D003319:Corneal Stroma / Q000187:drug effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006084:Graft Rejection / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D007267:Injections; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D005938:Glucocorticoids; D001623:Betamethasone