THE USE OF COMBINED INTRAVENOUS PULSE METHYLPREDNISOLONE AND ORAL CYCLOSPORINE-A IN THE TREATMENT OF CORNEAL GRAFT-REJECTION - A PRELIMINARY-STUDY

Purpose Oral cyclosporin A used in addition to high-dose intravenous p ulse methylprednisolone has been shown to have an adjunctive effect in reversing the rejection of liver and renal transplants. The aim of th is prospective study was to evaluate the benefits and risks of this co mbined drug therapy in acute corneal graft rejection. Methods Eleven p atients with acute conceal graft rejection received the combined regim en of a single pulse of intravenous methylprednisolone (500 mg) and a low dose of oral cyclosporin A (to maintain a trough blood level of 10 0-200 mu g/l). Results At a mean follow-up of 16.5 months (range 8-22 months) from the presentation of the graft rejection, reversal of graf t rejection was achieved in 10 of 11 cases (90.9%). No recurrence of g raft rejection was encountered during the study period. One patient de veloped a duodenal ulcer, which healed after medical treatment. No oth er complications were encountered. Conclusions The high efficacy and l ow risk of the combined regimen demonstrated in this preliminary study call for a larger-scale prospective double-masked study to confirm th e value of this treatment protocol.