Long-term topical steroid treatment improves graft survival following normal-risk penetrating keratoplasty.

Author(s): Nguyen NX, Seitz B, Martus P, Langenbucher A, Cursiefen C

Affiliation(s): Department of Ophthalmology, University of Erlangen-Nurnberg, Erlangen, Germany.

Publication date & source: 2007-08, Am J Ophthalmol., 144(2):318-9.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

PURPOSE: To assess the impact of duration of topical steroid treatment on the incidence of endothelial graft rejection after normal-risk penetrating keratoplasty (PK). DESIGN: Prospective, institutional, longitudinal, randomized interventional trial including 406 eyes (age 52 +/- 19 years; follow-up 42 +/- 18 months). METHODS: Postoperative treatment started with prednisolone acetate 1% eye drops five times daily and was tapered over the first six months. Patients were then randomized into either short-term (stop topical steroid treatment) or long-term treatment (continue steroids once daily for 12 months). RESULTS: During follow-up, 29 eyes (7.1%) developed an episode of endothelial graft rejection. Graft rejections were significantly more common in the short-term (19 of 202; 9.1%) compared with the long-term treatment group (10 of 204: 4.9%; P = .001). CONCLUSIONS: Long-term, low-dose topical steroid treatment protects against immunologic graft rejections.