Long-term effects of topical cyclosporine A treatment after penetrating keratoplasty

PURPOSE: To evaluate the long-term outcome of topical 2% cyclosporine A (CsA) treatment as an adjunct to topical corticosteroid treatment of patients after penetrating keratoplasty (PKP). METHODS: We reviewed the records of 83 patients (86 eyes) who had undergone PKP and received topical CsA treatment postoperatively; also the records of 95 PKP patients (97 eyes) who received the same treatment, except for the 2% CsA eyedrops, and served as controls. The patients were also subdivided into high-risk and low-risk groups. The clinical outcome of PKP was evaluated by the rates of graft survival and rejection-free graft survival, using the Kaplan-Meier method, and compared with the log-rank test. RESULTS: In the high-risk patients, the rejection-free graft survival rate was 69.7% in the CsA group and 45.4% in the control group (P =.030), but there was no significant difference in the graft survival rate between the two groups. CONCLUSION: Topical cyclosporine treatment is effective in reducing the risk of allograft rejection in high-risk patients.