[Influence of cyclosporin on steroid-induced cataract]

To study the effect of cyclosporin on steroid-induced cataract in patients after renal transplantation.

140 patients who received renal transplantation and ophthalmological examinations before and over 12 months after surgery at Kanazawa Medical University were investigated retrospectively. The subjects were divided into the following two groups: the conventional therapy group(Group C) who were administered azathioprin and methylprednisolone and the triple therapy group(Group T) who were administered azathioprin, methylprednisolone and cyclosporin. There were 73 subjects in group C and 67 in group T. Judgement of steroid cataract followed Crew's classification and steroid cataract was diagnosed when vacuoles or opacity were seen in the posterior subcapsular region. Subjects that had any lens opacity before renal transplantation were excluded.

The total dose of systemic steroid during the first year and in the final observation period in group T was significantly higher than in group C. The prevalence of steroid cataract was 55% and 63% for the 1st year, 72% and 89% for the 2nd year, 74% and 92% for the 3rd year and 83% and 96% for the 5th year in groups C and T, respectively. By the third year, the rate of subjects whose corrected visual acuity was less than 0.8 or who received cataract surgery was significantly higher in group T than in group C. There was no significant difference in the total dose between the subjects with cataract over grade I and those of grade 0 and I in both groups C and T. In group C, the total dose of steroid pulse therapy was significantly higher in the subjects with steroid cataract over grade I than in those with grade 0 and I.

Using cyclosporin, although the total dose of systemic steroid was decreased, the rate of steroid cataract increased. Cyclosporin may accelerate the development of steroid cataract. Steroid pulse therapy is considered to be a risk factor for developing steroid cataract.