Topical cyclosporine in pediatric keratoplasty

To evaluate the efficacy and safety of combined treatment with 2% topical cyclosporine (CsA) and topical corticosteroid compared to treatment with topical corticosteroids only after pediatric keratoplasty.

Twenty-two grafts in 16 pediatric patients were evaluated retrospectively. The eyes were divided into a CsA group (9 eyes) and a control group (13 eyes) based on the postoperative treatment regimen. Information reviewed included patient age and sex, clinical diagnosis; preoperative and postoperative intraocular pressure and lens status; previous, concurrent, and subsequent surgical procedures; operative and postoperative complications; number of graft rejections, timing of suture removal, and length of follow-up. The clinical outcome of penetrating keratoplasty (PK) was evaluated by the rate of rejection-free graft survival and graft survival evaluation by the Kaplan-Meier log-rank test.

The rejection-free graft survival rate was 88.9% in the CsA group and 38.5% in the control group. This difference in rejection-free graft survival rate between the groups was statistically significant (P =.0465). The graft survival rate was 88.9% in the CsA group and 46.2% in the control group. The difference in the graft survival rate was not statistically significant between the groups (P =.6). No clinical signs of systemic or local toxicity were seen with the topical CsA treatment.

Two percent topical CsA is safe and effective in reducing the risk of allograft rejection in pediatric recipients.