[Cyclosporin A combined with dexamethasone in preventing and treating immune rejection after penetrating keratoplasty].
OBJECTIVE
To evaluate the efficacy of topical 1% cyclosporin A (CsA), 0.1% dexamethasone or 1% CsA combined with 0.1% dexamethasone in preventing and treating immune rejection after penetrating keratoplasty (PKP).


METHODS
Eighty-six eyes from 86 PKP patients were randomly divided into 3 groups: (1) Thirty-one eyes were treated with 1% CsA and dexamethasone for 3 months. (2) Twenty-nine eyes were treated with 1% CsA for 3 months; (3) Twenty-six eyes were treated with 0.1% dexamethasone for 3 months. The rejected eyes of postoperation were given with the dexamethasone injection under conjunctiva and increased the frequency of CsA and dexamethasone eye drops. All patients were followed up for 1 to approximately 2 years.


RESULTS
There was a statistical difference in the 3 groups in the postoperative immune rejection which occurred in 5 out of 29 (17.3% ) eyes treated with 1% CsA, 7 out of 26 (26.9%) treated with 0.1% dexamathasone, and 3 out of 31 (9.7%) with 1% CsA and dexamethasone. The immune rejection after PKP occurred in 15 eyes and 13 eyes were cured by sub-conjunctiva injection of dexamethasone combined with eye drops of 1% CsA and 0. 1% dexamethasone.


CONCLUSIONS
The efficacy of CsA combined with dexamethasone topically is better than that of 1% CsA or 0.1% dexamethasone alone in preventing rejection episodes. It is effective to cure the graft rejection after PKP with sub-conjunctiva injection of dexamethasone combined with the eye drop of 1% CsA and 0.1% dexamethasone.
Xi
Xing-hua
XH
Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Qin
Bo
B
Jiang
De-yong
DY
D000328:Adult; D003318:Corneal Opacity / Q000601:surgery; D016572:Cyclosporine / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged
D007166:Immunosuppressive Agents; D003907:Dexamethasone; D016572:Cyclosporine