Treatment of Corneal Endothelial Rejection With Intracamerular Triamcinolone

Abstract

Abstract: : Purpose: To report the efficacy of intracamerular injection of 4 mg triamcinolone in the treatment of corneal endothelial rejection after penetrating keratoplasty. Methods: Prospective study of 22 eyes of 22 patients with acute endothelial rejection ( ER) ( 10 with diffuse ER, 10 presenting 2/3 of cornea with ER and 2 with 1/3 of cornea with ER ) treated with an intracamerular injection of triamcinolone (4 mg/0,1 ml), followed by topical gatifloxacin (QID) for 4 days. Patients were submitted to ophthalmologic evaluations on day 1, 7, 15 , 30, 60 and 90. Results:Currently the follow up is 30 days. The majority of the cases (55,5%) improved clinically within 7 days. In 18 patients (81,8%) the clinical evaluation showed an improvement of corneal edema and Snellen visual acuity improved by at least two lines. Four patients presented recurrence of the endothelial rejection after 30 days and received a second injection with improvement of visual acuity in 15 days. Three patients, experienced increased intraocular pressure to 30 mmhg that was controlled with topical medications. Two of those patients presented glaucoma priory to the treatment.Conclusions: Intracamerular injection of 4 mg triamcinolone appears to be an effective alternative for the treatment of corneal endothelial rejection after penetrating keratoplasty.

Keywords: transplantation • corticosteroids