Treatment with cyclosporin A, with low doses, in high-risk penetrating keratoplasties. A bi-centric study of 90 cases

PURPOSE: Evaluation of cyclosporin-A in prevention of immune reaction in high-risk penetrating keratoplasties. MATERIAL AND METHODS: Cyclosporin A was given to 45 corneal allograft recipients, 5 mg/kg/j (cyclosporinemy between 100 and 150 ng/l), for three months following surgery. 45 controls have undergone penetrating keratoplasty during the same period. Mean follow-up was respectively 431 days and 402 days. Survival was analysed according to Kaplan-Meier's method, and then using Cox model. RESULTS: The significant predictive factors were the number of neovascularized quadrants, and the graft diameter. No significant effect of cyclosporin is evidenced. Side effects are marginal. CONCLUSION: Three hypothesis may explain the absence of prognosis improvement in the Cyclosporin A treated group: insufficient dose or duration of treatment, individual risk factors that prevents correct pairing, or corneal-specific immunological mechanisms.