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Local therapy of corneal allograft rejection with cyclosporine
1Department of Microbiology and Immunology, Beijing Institute of Ophthalmology, People's Republic of China.
Purpose:
We evaluated the therapeutic effect of 0.5% topical cyclosporine on human corneal allograft rejection.
Methods:
Sixteen patients (16 eyes) with corneal allograft rejection, refractory to the conventional treatments, were recruited and treated with 0.5% cyclosporine eyedrops in this study.
Results:
Of 16 eyes with corneal graft rejection after penetrating keratoplasty treated with 0.5% cyclosporine eyedrops, nine eyes were completely cured, six eyes improved markedly, and treatment was ineffective in one eye. A follow-up of 12 to 24 months (three eyes for 12 months, five eyes for 18 months, and eight eyes for 24 months) disclosed that rejection recurred in three of the nine cured eyes--two eyes after suspension of cyclosporine and one eye after removal of the sutures. The recurrence of rejection resolved by resumption of the cyclosporine eyedrops.
Conclusions:
This study demonstrated that treatment of corneal graft rejection with 0.5% topical cyclosporine yielded good results in eyes with satisfactory preoperative corneal transplantation beds and beneficial effects in eyes with poor preoperative corneal transplantation beds.
Insights
Topical cyclosporine eyedrops effectively treated human corneal allograft rejection, even in difficult cases. Recurrence was managed by resuming treatment, showing its therapeutic value.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Corneal allograft rejection is a significant complication following penetrating keratoplasty.
- Conventional treatments for corneal graft rejection are often refractory.
Purpose of the Study:
- To evaluate the therapeutic efficacy of 0.5% topical cyclosporine in managing human corneal allograft rejection.
- To assess the effectiveness of cyclosporine in both satisfactory and poor preoperative corneal transplantation beds.
Main Methods:
- A cohort of 16 patients with refractory corneal allograft rejection was treated with 0.5% topical cyclosporine eyedrops.
- Patients were monitored for treatment response and graft survival over a 12 to 24-month follow-up period.
Main Results:
- Nine out of 16 eyes achieved complete resolution of rejection, while six showed marked improvement.
- One eye did not respond to treatment.
- Recurrence of rejection in three cured eyes was successfully managed by reinitiating cyclosporine therapy.
Conclusions:
- 0.5% topical cyclosporine demonstrates significant therapeutic benefits for corneal graft rejection.
- The treatment is effective in eyes with both favorable and unfavorable preoperative corneal transplantation conditions.
- Cyclosporine offers a viable option for managing recurrent corneal allograft rejection.
