Purpose: To evaluate the efficacy of combined treatment with commercially available 0.05% topical cyclosporine (CsA) and topical corticosteroid compared to treatment with topical corticosteroids only after high risk keratoplasty.
Patients and Methods: A total of 47 high-risk keratoplasties were randomly divided into two groups based on the postoperative immunosuppression. Twenty-five eyes (Group 1) were treated with 0.05% CsA and dexamethasone 0.1%, and 22 eyes (Group 2) were treated with dexamethasone only. The clinical outcome of penetrating keratoplasty (PK) was evaluated by the rate of rejection-free graft survival and graft survival evaluation by the Kaplan-Meier log-rank test.
Results: The avarage length of follow-up was 20.2±7.1 months in group1 and 18.5±6.6 months in group 2 (p=0.421). Rejection-free graft survival rates were 60.8% in group 1, and 54.5% in group 2 (Kaplan-Meier log-rank test, p=0.474). In group 1, the graft survival rate was 73.9%; in group 2, the graft survival rate was 68.1%. The difference in the graft survival rates between the groups was also not statistically significant (Kaplan-Meier log-rank test, p=0.518).
Conclusion: In high risk corneal grafts, the efficacy of 0.05 percent commercially available topical cyclosporine combined with dexamethasone topically was not better than that of dexamethasone alone in preventing rejection.