Purchase this article with an account.
Nallely Ramos Betancourt, Valeria Sanchez-Huerta, Claudia Ortiz Valencia, Luz Elena Concha del Río, Carla Rocío Robles Reyes; Methotrexate and graft survival in high risk corneal transplantations. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5666.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate clinical outcomes in patients treated with methotrexate for high-risk corneal transplantation
Study Population: Patients were prospectively recruited at Cornea Department from 2014 to 2016, after Institutional Review Board approval and obtaining informed consent from all patients. Inclusion criteria: Patients that require penetrating keratoplasty and have high-risk characteristics, which include: 2 or more quadrants of deep vascularization and/or previous graft rejection. Patients with a history of nephropathy, liver or hematological disease were excluded. In total, 18 patients were screened and 2 were excluded from analysis based on: insufficient follow-up (<6months). Methotrexate dosing and monitoring: Parenteral methotrexate was administered a month prior to surgery (starting with 10mg weekly). The day of the surgery, the dose was increased to 15mg, and after a month to 20mg/week. Laboratory work-up was made prior to methotrexate therapy, prior to surgery, and every 3 months after surgery. Adverse events were assessed every visit. Main outcome measures: Survival of grafts. Statistical Analysis: Data were entered into a standardized database. Statistical analyses were performed using SPSS 22.0 .Survival analysis of grafts was evaluated with Kaplan Meier survival analysis.
Demographics of study population: 16 patients were included in the study. Mean age was 44.63 years (SD 23,56) and 68,8% (11) were men. Graft survival: Mean time of graft survival was 13,25 months (SD 2.89, range 9-24 months). Graft survival in the first year of follow-up was 83,3%. Side effects of treatment: Only 2 patients reported dyspepsia during the first weeks of treatment.
Graft survival in high-risk corneal transplantation patients treated with methotrexate was 83,3% in the first year. Since methotrexate is cheap, safe and has less adverse effects compared to other treatments, further comparative studies should be considered.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only