June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Methotrexate and graft survival in high risk corneal transplantations
Author Affiliations & Notes
  • Nallely Ramos Betancourt
    Cornea and Refractive Surgery, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
  • Valeria Sanchez-Huerta
    Cornea and Refractive Surgery, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
  • Claudia Ortiz Valencia
    Cornea and Refractive Surgery, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
  • Luz Elena Concha del Río
    Uveitis, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
  • Carla Rocío Robles Reyes
    Cornea and Refractive Surgery, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
  • Footnotes
    Commercial Relationships   Nallely Ramos Betancourt, None; Valeria Sanchez-Huerta, None; Claudia Ortiz Valencia, None; Luz Concha del Río, None; Carla Rocío Robles Reyes, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5666. doi:
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    • Get Citation

      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.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate clinical outcomes in patients treated with methotrexate for high-risk corneal transplantation

Methods : 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.

Results : 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.

Conclusions : 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.

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