Purpose: To perform a retrospective study to evaluate the long-term outcome
of systemic cyclosporine treatment as an adjunct to topical corticosteroid
treatment after penetrating keratoplasty (PKP).
Methods: Twenty-six high-risk patients (27 eyes) who received systemic cycl
osporine following PIC-P for an average of 5.4 months were compared with an
other series of 57 patients (57 eyes) who did not receive cyclosporine afte
r PKP.
Results: Endothelial rejection developed in 2 cases during cyclosporine tre
atment and in 6 cases after discontinuation. The rate of rejection-free gra
ft survival was similar between the treated and the control groups. The con
trol group showed a significantly higher rate of graft survival than the tr
eated group. As side effects in the treatment group, transient elevation in
blood urea nitrogen or creatine developed in 7 cases. Increase in glutamet
e oxaloacetate transaminase (GOT) or glutamete pyrubate transaminase (GPT)
developed in 4 cases. Severe side effects were absent throughout the series
in both groups of patients.
Conclusion: Systemic cyclosporine treatment for several months did not redu
ce the. incidence of rejection nor improve the rate of graft clarity in the
long term in high-risk patients after PKP. Jpn J Ophthalmol 2001;45:378-38
2 (C) 2001 Japanese Ophthalmological Society.