[Preventive systemic cyclosporin A in risk keratoplasty]

Systemic cyclosporin A prophylaxis was applied in 18 high-risk corneal transplants. Immunoreactions occurred in three cases. They correlated with too low serum level of cyclosporin A. Two of them could be reversed by an increase of cyclosporin A dosage in combination with an intensive corticosteroid therapy. Four corneal transplants failed from persistent severe basic disease. Eleven corneal transplants remained clear during the follow-up (5-33 months). A constant trough cyclosporin A serum level of 100-120 ng/ml has been shown to exert efficient immunomodulating effects. We currently judge a postoperative prophylaxis period of 6 to 12 months with cyclosporin A to be sufficient in most high-risk cases.