Abstract
PURPOSE: To report long-term results in a case series of patients treated with systemic immune suppression for prevention of penetrating keratoplasty (PKP) graft rejection. DESIGN: Retrospective noncomparative chart review. PARTICIPANTS: Three patients presented with PKP graft failure. METHODS: Patients received oral prednisone, azathioprine and cyclosporine to prevent rejection of repeat corneal transplant. Patients received repeat PKP and graft outcome was reported. MAIN OUTCOME MEASURES: Visual acuity and graft survival were recorded. RESULTS: Mean age was 55 years, two male and one female. Mean follow-up period was 37 months (range 24-46). All three patients completed the treatment protocol with minimal adverse effects. All grafts remained clear over observational period. CONCLUSION: Our study suggests that systemic immune suppression with 2 or more agents may be helpful to prevent corneal graft rejection in high-risk patients.
Highlights
To report long-term results in a case series of patients treated with systemic immune suppression for prevention of penetrating keratoplasty (PKP) graft rejection
We hypothesized that a tailored combination of systemic prednisone, azathioprine, and cyclosporine A (CsA) may be an effective regimen in high-risk regraft
At POM 9, early signs of graft rejection became evident and the patient was urgently started on prednisolone acetate q3h, CsA q4h, and oral prednisone, in combination with azathioprine
Summary
To report long-term results in a case series of patients treated with systemic immune suppression for prevention of penetrating keratoplasty (PKP) graft rejection. We hypothesized that a tailored combination of systemic prednisone, azathioprine, and cyclosporine A (CsA) may be an effective regimen in high-risk regraft. We described the visual outcome and graft survival of high-risk corneal transplant patients who received systemic immunosuppression prior to re-graft.
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