| The Efficacy of Low-Dose Systemic Cyclosporine for Graft Failure after Penetrating Keratoplasty in High-Risk Group. |
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Young Joo Cho, Eung Kweon Kim, Hyung Keun Lee |
1Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. shadik@yuhs.ac
2Institute of Corneal Dystrophy Research, Yonsei University College of Medicine, Seoul, Korea.
3Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea. |
| 각막이식 거부반응 고위험군에서 전층각막이식술 후 저용량 사이클로스포린 투약에 따른 이식실패율 |
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조영주1⋅김응권1,2⋅이형근1,3 |
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine1, Seoul, Korea.
Institute of Corneal Dystrophy Research, Yonsei University College of Medicine2, Seoul, Korea.
Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine3, Seoul, Korea |
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| Abstract |
PURPOSE
To investigate the effect of low-dose systemic cyclosporine A (CsA) in preventing graft failure after high-risk penetrating keratoplasty (PKP). METHODS: In this retrospective study, 36 eyes of 25 patients who underwent PKP were evaluated. At 24 months postoperatively, the failure rate in the CsA group (n = 19) was compared to the control group (n = 17). For subgroup analysis, the failure rate in the CsA group (n = 9) and control group (n = 9) was compared in patients who underwent a repeat PKP. The patients' side-effect profile was also collected. RESULTS: The median follow-up in the CsA group was 32.8 months and 28.9 months in the control group. Graft failure occurred in 31.6% CsA patients and in 68.4% control patients (p = 0.311). In patients with repeat PKP, the failure rate in the CsA group was significantly lower than the control group (22.2% vs. 77.8%, p = 0.018). In one case (5.26%), CsA was discontinued due to gastroinstestinal discomfort. CONCLUSIONS: Low-dose CsA was not beneficial compared to conventional therapy in high-risk PKP patients. However, in the repeat PKP subgroup, the incidence of graft failure was lower with low-dose CsA than with conventional therapy. Although further study is necessary, adding low-dose CsA might be beneficial for repeat PKP patients. |
| Key Words:
Corneal graft failure;Cyclosporin A;Penetrating keratoplasty |
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