[Long-term outcome of topical cyclosporine treatment following penetrating keratoplasty].

PURPOSE

To evaluate the long-term outcome of 2% topical cyclosporine A (CsA) treatment as an adjunct to topical corticosteroid in 86 eyes after penetrating keratoplasty (PK).

MATERIAL AND METHODS

The subjects were 86 eyes of 83 patients who had undergone PK and received topical CsA treatments. Ninety-seven eyes of 95 patients who had undergone PK and received similar postoperative treatments except for topical CsA treatments served as control: The clinical outcome of PK was evaluated by rates of graft survival and rejection-free graft survival using Kaplan-Meier's method and compared with the log-rank test. The patients were subdivided into high-risk and low-risk groups. The high-risk patients were those who had corneal vascularization in 2 or more quadrants of the cornea preoperatively or who received regrafting. All other patients were assigned to the low-risk group. Thirty-six eyes of the CsA group and 50 eyes of the control group were high-risk cases.

RESULTS

In the high-risk patients, the rejection-free graft survival rate was 69.7% in the CsA group and 45.4% in the control group (p = 0.030). However, there was no significant difference in the graft survival rate between the two groups. In the low-risk patients, there was no significant difference in the rates of rejection-free graft survival and graft survival between the CsA and the control group.

CONCLUSION

2% topical cyclosporine is effective in reducing the risk of allograft rejection in high-risk recipients.