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Johannes Schwartzkopff, Katrin Wacker, Yvonne Kern, Laura Bredow, Antonia Hildebrand, Thomas Reinhard; Strong Anti-inflammatory Effect Of Topical Ayzthromycin Following Corneal Transplantation. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2372.
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Any inflammatory response following corneal transplantation may induce rejection and irreversible graft failure. Azythromycin (AZM) efficiently inhibits inflammation at the eyelid margins and in experimental dry eye disease. It was the purpose to analyze the anti-inflammatory efficacy of AZM following keratoplasty in the rat.
Corneal transplants were performed between Lewis recipient and Fisher donor rats. Recipients were treated topically for two weeks with AZM. Control animals received topical mygliol or dexamethasone in an allogeneic or AZM in the syngeneic setting. All transplants were monitored clinically. Infiltration of CD45, CD4, CD8, CD25, CD161 and CD163 was stained histologically.
AZM significantly promoted corneal graft survival (p<0.01). Initially the clinical effect was comparable to dexamethasone. However, more pathological vessels established and some AZM-treated recipients rejected whereas all dexamethasone-treated rats did not reject at any time point. No negative side effect was observed in AZM-treated syngeneic rats. Histology confirmed the clinical finding with massively reduced numbers of infiltrating T cells, macrophages and NK cells (p<0.01, respectively).
Topical azythromycin has a strong anti-inflammatory effect following keratoplasty. In 50% of cases this is comparable to topical dexamethasone and sufficient to promote allograft survival in rat keratoplasty. Therefore, we suggest the additive use of topical AZM following keratoplasty.
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