[Ranking of systemic steroids after normal-risk keratoplasty. Results of a randomized prospective study].
BACKGROUND
The aim of this study was to evaluate the efficacy of sole application of topical steroids after normal-risk keratoplasty.


METHODS
This randomized prospective clinical study assessed 40 patients who had undergone penetrating normal-risk keratoplasty. Twenty patients were treated exclusively with prednisolone acetate 1% eye drops 5x/day for 6 months postoperatively. Another 20 patients additionally received systemic fluocortolone 1 mg/kg body weight per day tapered within 3 weeks postoperatively. The main outcome measures included clear graft survival, ratio of graft rejection, and side effects.


RESULTS
The mean postoperative follow-up was 18+/-9 months. Three graft rejections were observed in the group receiving only topical steroids. Two graft rejections were observed in the group administered combined systemic and topical steroid therapy. None of the patients has developed irreversible graft failure so far.


CONCLUSIONS
Sole topical steroid application seems to be an effective immune prophylaxis in patients undergoing penetrating normal-risk keratoplasty.
Mayweg
S
S
Augenklinik, Heinrich-Heine-Universität, Düsseldorf. susan.mayweg@gmx.de
Reinhard
T
T
Spelsberg
H
H
Reis
A
A
Godehardt
E
E
Sundmacher
R
R
D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003627:Data Interpretation, Statistical; D005260:Female; D005448:Fluocortolone / Q000008:administration & dosage* / Q000009:adverse effects; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010865:Pilot Projects; D011184:Postoperative Period; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions; D005448:Fluocortolone; C009935:prednisolone acetate; D011239:Prednisolone