LOW-DOSAGE CYCLOSPORINE-A IN PENETRATING KERATOPLASTY - A BICENTRIC STUDY OF 90 CASES

Purpose Evaluation of ciclosporin-A in prevention of immune reaction i n high-risk penetrating keratoplasties. Material and methods Ciclospor in A was given to 45 corneal allograft recipients, 5 mg/kg/j (ciclospo rinemy between 100 and 150 ng/l), for three months following surgery. 45 controls have undergone penetrating keratoplasty during the same pe riod. Mean follow-up was respectively 431 days and 402 days. Survival was analysed according to Kaplan-Meier's method, and then using Cox mo del. Results The significant predictive factors were the number of neo vascularized quadrants, and the graft diameter. No significant effect of ciclosporin is evidenced. Side effects are marginal. Conclusion Thr ee hypothesis may explain the absence of prognosis improvement in the Ciclosporin A treated group: unsufficient dose or duration of treatmen t, individual risk factors that prevents correct pairing, or corneal-s pecific immunological mechanisms.