Evaluation of topical ciclosporin 0.05% for prevention of rejection in high-risk corneal grafts.
OBJECTIVE
To evaluate the efficacy of combined treatment with commercially available 0.05% topical ciclosporin and topical corticosteroid compared with treatment with topical corticosteroids only after high-risk keratoplasty.


METHODS
A total of 47 high-risk keratoplasties were randomly divided into two groups based on the postoperative immunosuppression. Twenty-five eyes (group 1) were treated with 0.05% ciclosporin and dexamethasone 0.1%, and 22 eyes (group 2) were treated with dexamethasone only. The clinical outcome of penetrating keratoplasty was evaluated by the rate of rejection-free graft survival and graft survival evaluation by the Kaplan-Meier logrank test.


RESULTS
The average length of follow-up was 20.2 (SD 7.1) months in group 1 and 18.5 (6.6) months in group 2 (p = 0.421). Rejection-free graft survival rates were 60.8% in group 1 and 54.5% in group 2 (Kaplan-Meier logrank test, p = 0.474). In group 1, the graft survival rate was 73.9%; in group 2, the graft survival rate was 68.1%. The difference in the graft survival rates between the groups was also not statistically significant (Kaplan-Meier logrank test, p = 0.518).


CONCLUSIONS
In high-risk corneal grafts, the efficacy of 0.05 percent commercially available topical ciclosporin combined with dexamethasone topically was not better than that of dexamethasone alone in preventing rejection.
Unal
M
M
Akdeniz University Medical Faculty, Department of Ophthalmology, Antalya, Turkey. mustafaunalmd@gmail.com
Yücel
I
I
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D003316:Corneal Diseases / Q000601:surgery; D016039:Corneal Transplantation / Q000379:methods*; D016572:Cyclosporine / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004333:Drug Administration Routes; D004728:Endothelium, Corneal / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006087:Graft vs Host Reaction / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D003907:Dexamethasone; D016572:Cyclosporine