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Adriano J. Carpizo, Alejandro Babayan-Sosa, Oscar Baca-Lozada, Oscar Fernandez-Vizcaya, Simon Romano-Bucay, Regina Velasco-Ramos; Intravenous Corticosteroid Treatment In Endothelial Corneal Allograft Rejection: Efficacy And Safety. Invest. Ophthalmol. Vis. Sci. 2011;52(14):373.
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To determine the efficacy and safety of intravenous corticosteroid treatment in endothelial corneal allograft rejection
This is a comparative study between a control group of patients treated with topical corticosteroid 1% prednisolone acetate only, and a group of patients with an acute endothelial allograft rejection episode. (No longer than eight days) The treatment consisted in 500 mg pulsed intravenous methylprednisolone. A written consent was given. The presence of any adverse event or secondary reaction during treatment was recorded. Follow up treatment was with topical corticosteroid 1% prednisolone acetate. Efficacy of the treatment was defined as the reversal of the rejection episode if the corneal graft was clear and free of edema
Nine patients were treated with 1% topical prednisolone acetate and pulsed intravenous methylprednisolone at the diagnosis of corneal allograft rejection and 11 patients were submitted to topical treatment only. 5 patients (66%) that were submitted to pulsed steroid had a good outcome, 2 patients (22%) presented corneal graft failure, while only 6 patients (55%) that received only topical steroids resulted with clear grafts and 2 patients (18%) with graft failure. No adverse effects or secondary reactions of intravenous methylprednisolone were observed
This study suggests that the use of 500 mg intravenous methylprednisolone in addition to 1% topical prednisolone acetate presents a faster recovery in symptoms and clinically in reverting corneal allograft rejection when compared to the single use of 1% topical prednisolone acetate. Even though there are problems associated with this route of administration, when safety measures are taken adverse effects are lowered
Clinical Trial: :
Fundación Hospital Nuestra Señora de la Luz, IAP, 0
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