Unal M, Yücel I
Akdeniz University Medical Faculty, Department of Ophthalmology, Antalya, Turkey.
Br J Ophthalmol. 2008 Oct;92(10):1411-4. doi: 10.1136/bjo.2008.143024. Epub 2008 Jul 28.
To evaluate the efficacy of combined treatment with commercially available 0.05% topical ciclosporin and topical corticosteroid compared with treatment with topical corticosteroids only after high-risk keratoplasty.
A total of 47 high-risk keratoplasties were randomly divided into two groups based on the postoperative immunosuppression. Twenty-five eyes (group 1) were treated with 0.05% ciclosporin and dexamethasone 0.1%, and 22 eyes (group 2) were treated with dexamethasone only. The clinical outcome of penetrating keratoplasty was evaluated by the rate of rejection-free graft survival and graft survival evaluation by the Kaplan-Meier logrank test.
The average length of follow-up was 20.2 (SD 7.1) months in group 1 and 18.5 (6.6) months in group 2 (p = 0.421). Rejection-free graft survival rates were 60.8% in group 1 and 54.5% in group 2 (Kaplan-Meier logrank test, p = 0.474). In group 1, the graft survival rate was 73.9%; in group 2, the graft survival rate was 68.1%. The difference in the graft survival rates between the groups was also not statistically significant (Kaplan-Meier logrank test, p = 0.518).
In high-risk corneal grafts, the efficacy of 0.05 percent commercially available topical ciclosporin combined with dexamethasone topically was not better than that of dexamethasone alone in preventing rejection.
评估在高危角膜移植术后，与仅使用局部皮质类固醇治疗相比，联合使用市售0.05%局部环孢素和局部皮质类固醇治疗的疗效。
根据术后免疫抑制情况，将47例高危角膜移植术随机分为两组。25只眼（第1组）接受0.05%环孢素和0.1%地塞米松治疗，22只眼（第2组）仅接受地塞米松治疗。通过无排斥反应的移植物存活率和Kaplan-Meier对数秩检验评估穿透性角膜移植术的临床结果。
第1组的平均随访时间为20.2（标准差7.1）个月，第2组为18.5（6.6）个月（p = 0.421）。第1组无排斥反应的移植物存活率为60.8%，第2组为54.5%（Kaplan-Meier对数秩检验，p = 0.474）。在第1组中，移植物存活率为73.9%；在第2组中，移植物存活率为68.1%。两组之间移植物存活率的差异也无统计学意义（Kaplan-Meier对数秩检验，p = 0.518）。
在高危角膜移植中，市售0.05%局部环孢素联合地塞米松局部应用在预防排斥反应方面的疗效并不优于单独使用地塞米松。
