title: [Advantages and limits of multiple grafts (third keratoplasty) under local cyclosporin 2%].
abstract: BACKGROUND
  iterative penetrating keratoplasty procedures (PKPs) increase the risk of graft rejection. Surgeons are reluctant to perform a third procedure following two previous graft failures. We evaluated the outcomes of patients who had three successive PKPs treated with a local combination of cyclosporin 2% A and dexamethasone 0.1% eye drops.
  
  
  METHODS
  this is a retrospective study of a series of cases including 15 eyes of 15 patients treated and followed in the ophthalmology unit at the Hôtel-Dieu Hospital in Paris (2006-2009).
  
  
  RESULTS
  after an average follow-up of 20.5±2 months, the risk of transplant rejection was 13.33% and the duration of follow-up corresponded in all patients to the duration of treatment with cyclosporin eye drops. The treatment was not interrupted by any patient because of intolerance.
  
  
  CONCLUSIONS
  in this study, we observed a success rate justifying the indication of the third keratoplasty under local cyclosporin 2% classically considered debatable.
authors.affiliation: Service d'ophtalmologie, hôpital Hôtel-Dieu, 1, place du Parvis-Notre-Dame, 75181 Paris cedex 04, France.
authors.forename: H
authors.initials: H
authors.lastname: Alalwani
authors.forename: B
authors.initials: B
authors.lastname: Omer Saleh
authors.forename: N
authors.initials: N
authors.lastname: Rocher
authors.forename: G
authors.initials: G
authors.lastname: Renard
authors.forename: J-L
authors.initials: JL
authors.lastname: Bourges
authors.forename: J-M
authors.initials: JM
authors.lastname: Legeais
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016039:Corneal Transplantation / Q000706:statistics & numerical data*; D016572:Cyclosporine / Q000008:administration & dosage*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine