Nguyen Nhung X, Seitz Berthold, Martus Peter, Langenbucher Achim, Cursiefen Claus
Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany.
Am J Ophthalmol. 2007 Aug;144(2):318-9. doi: 10.1016/j.ajo.2007.03.028.
To assess the impact of duration of topical steroid treatment on the incidence of endothelial graft rejection after normal-risk penetrating keratoplasty (PK).
Prospective, institutional, longitudinal, randomized interventional trial including 406 eyes (age 52 +/- 19 years; follow-up 42 +/- 18 months).
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).
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).
Long-term, low-dose topical steroid treatment protects against immunologic graft rejections.
评估正常风险穿透性角膜移植术（PK）后局部类固醇治疗持续时间对内皮植片排斥发生率的影响。
前瞻性、机构性、纵向、随机干预试验，纳入406只眼（年龄52±19岁；随访42±18个月）。
术后治疗开始时使用1%醋酸泼尼松龙滴眼液，每日5次，在最初6个月逐渐减量。然后将患者随机分为短期治疗组（停止局部类固醇治疗）或长期治疗组（继续每日一次使用类固醇12个月）。
随访期间，29只眼（7.1%）发生了内皮植片排斥事件。与长期治疗组（204只眼中的10只；4.9%；P = 0.001）相比，短期治疗组（202只眼中的19只；9.1%）的植片排斥明显更常见。
长期、低剂量局部类固醇治疗可预防免疫性植片排斥。
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