长期局部使用类固醇治疗可提高低风险穿透性角膜移植术后的植片存活率。
Long-term topical steroid treatment improves graft survival following normal-risk penetrating keratoplasty.
作者信息
Nguyen Nhung X, Seitz Berthold, Martus Peter, Langenbucher Achim, Cursiefen Claus
机构信息
Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany.
出版信息
Am J Ophthalmol. 2007 Aug;144(2):318-9. doi: 10.1016/j.ajo.2007.03.028.
PURPOSE
To assess the impact of duration of topical steroid treatment on the incidence of endothelial graft rejection after normal-risk penetrating keratoplasty (PK).
DESIGN
Prospective, institutional, longitudinal, randomized interventional trial including 406 eyes (age 52 +/- 19 years; follow-up 42 +/- 18 months).
METHODS
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).
RESULTS
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).
CONCLUSIONS
Long-term, low-dose topical steroid treatment protects against immunologic graft rejections.
目的
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。
设计
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）。
方法
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）。
结果
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。
结论
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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