Use of cyclosporin in the treatment of steroid resistant post-keratoplastyatopic sclerokeratitis

Aims-To demonstrate that oral cyclosporin is successful in the management o f steroid refractory post-keratoplasty atopic sclerokeratitis (PKAS). Methods-Series of three patients. Results-The patients developed PKAS between 2 and 11 days after surgery. Al l cases failed to respond to oral prednisolone 60-80 mg daily for 10-30 day s but resolved with the addition of systemic cyclosporin 5.0-7.5 mg/kg/day. There have been no relapses following withdrawal of therapy after 3-18 mon ths. Conclusions-PKAS is an uncommon, but severe, complication of corneal graft surgery and often responds to oral prednisolone treatment. Oral cyclosporin results in rapid resolution of PKAS in steroid unresponsive cases.