Long-term topical steroid treatment improves graft survival following normal-risk penetrating keratoplasty.
OBJECTIVE
To assess the impact of duration of topical steroid treatment on the incidence of endothelial graft rejection after normal-risk penetrating keratoplasty (PK).


METHODS
Prospective, institutional, longitudinal, randomized interventional trial including 406 eyes (age 52 +/- 19 years; follow-up 42 +/- 18 months).


METHODS
Postoperative treatment started with prednisolone acetate 1% eye drops five times daily and was tapered over the first six months. Patients were then randomized into either short-term (stop topical steroid treatment) or long-term treatment (continue steroids once daily for 12 months).


RESULTS
During follow-up, 29 eyes (7.1%) developed an episode of endothelial graft rejection. Graft rejections were significantly more common in the short-term (19 of 202; 9.1%) compared with the long-term treatment group (10 of 204: 4.9%; P = .001).


CONCLUSIONS
Long-term, low-dose topical steroid treatment protects against immunologic graft rejections.
Nguyen
Nhung X
NX
Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany.
Seitz
Berthold
B
Martus
Peter
P
Langenbucher
Achim
A
Cursiefen
Claus
C
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003316:Corneal Diseases / Q000601:surgery*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011355:Prodrugs; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions; D011355:Prodrugs; C009935:prednisolone acetate; D011239:Prednisolone