Long-term resolution of immunological graft rejection after a dexamethasone intravitreal implant.
OBJECTIVE
To present the results of the injection of an intravitreal implant of dexamethasone 0.7 mg (DEX 0.7 mg) in 4 patients with an immunologic graft rejection after penetrating keratoplasty.


METHODS
Two of the patients received DEX 0.7 mg because inflammation and corneal edema not related to endothelial cell loss persisted despite the administration of topical prednisolone acetate, subconjunctival betamethasone, and systemic methylprednisolone. The other 2 cases received DEX 0.7 mg at the time rejection was diagnosed.


RESULTS
At 1 and 6 months after implantation, all rejection episodes resolved with improvement in uncorrected and best-corrected visual acuity, restoration of graft transparency, reduction of central corneal thickness, and no significant increase in intraocular pressure.


CONCLUSIONS
In 4 eyes with an immunologic graft rejection after penetrating keratoplasty, the dexamethasone 0.7 mg intravitreal implant was an effective treatment option, even in cases refractory to standard topical and systemic therapy.
*Department of Ophthalmology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; †Division of Ophthalmology, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy; ‡Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, University Federico II, Naples, Italy; §Eye Clinic, University "Gabriele D'Annunzio" Chieti-Pescara, Chieti, Italy; and ¶Eye Research Institute, Bern, Switzerland.
Paolo
P
Vinciguerra
Elena
E
Albé
Riccardo
R
Vinciguerra
Mario R
MR
Romano
Mario M
MM
Romano
Silvia
S
Trazza
Leonardo
L
Mastropasqua
Daniel
D
Epstein
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006084:Graft Rejection / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D058449:Intravitreal Injections; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D014792:Visual Acuity
D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone