[Systemic cyclosporin A therapy in high risk keratoplasty]

The authors have treated seven patients (eight eyes) with systemic cyclosporin-A for up to 1.5 years after high-risk keratoplasty à chaud. The fellow eye was compromised in all except one of the patients treated. Two patients (three eyes) had had a corneal perforation as a result of alkali burns or herpetic keratouveitis without previous grafting; five patients (five eyes) had had multiple corneal grafts (up to three grafts in one eye). Each patient received the medication pre- and postoperatively in organ transplant concentrations. In each case reported, the graft survived; however, visual acuity was reduced due to epithelial problems in four of eight eyes. Cyclosporin A may help to provide a better prognosis for allogeneic keratoplasty in high-risk situations. Long-term results in larger populations and comparison with other modes of minimizing graft rejection will define the role of cyclosporin A in allogeneic high-risk keratoplasty.