Abstract
Abstract: :
Purpose: To evaluate the benefit of 2% topic Ciclosporin A in high risk penetrating keratoplasty patients. Methods: A prospective, longitudinal, transversal and observational study was done. We included patients with penetrating keratoplasty with a high risk of graft failure having one of the following: previous graft rejection, chemical injury (alkali).deep vascularization of more than 180° or infectious keratitis. We used 2% topic Ciclosporin A, which was prepared with 0.2cc of solution Ciclosporin A combined with 10cc polyvilinic alcohol, and kept it at 4ºC. We applied it twice a day since the first day postoperative. Our evaluation included visual acuity, corneal status, pachometry and specular microscopy. Patients were examined at 1st day, 1st week, 1st, 2nd, 3rd and 4th month. All of the patients had hematic and hepatic blood test. Results: We included 8 patients with an average age of 25 years, with a follow up of 4 months. The preoperative diagnosis were: vascularized leukoma secondary to penetrating ocular trauma in 2 patients, vascularized bullous keratopathy in 2 patients, chemical alkali burn in one patient, herpetic keratitis in one patient, bacterial keratitis in one and previous graft rejection in one patient. During the follow up only one patient (12.5%) has shown graft rejection, 3 patients (37.5%) remain with punctate superficial keratitis and conjunctivalization in one patient (12.5%). Visual acuity and transparence of the donor cornea has been stable during the follow up. The complementary studies were normal. Conclusion: Ciclosporin A is an excellent inmunosupressor agent and is a good option for high risk keratoplasty. It provides minimal ocular and non- systemic side effects up to now.
Keywords: 353 clinical (human) or epidemiologic studies: outcomes/complications • 371 cornea: endothelium • 607 transplantation