Topical 0.03% tacrolimus versus systemic mycophenolate mofetil as adjuncts to systemic corticosteroids for preventing graft rejection after repeat keratoplasty: one-year ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-01-07

AUTHORS

Amir Faramarzi, Hamed Abbasi, Sepehr Feizi, Yasaman Hadi, Amir A. Azari, Farid Karimian, Mohammad Reza Jafarinasab, Bahareh Kheiri

ABSTRACT

PurposeTo compare the efficacy of topical 0.03% tacrolimus in combination with systemic corticosteroids versus systemic mycophenolate mofetil (MMF) and corticosteroids in preventing corneal allograft rejection after repeat keratoplasty.MethodsThis prospective, randomized clinical trial enrolled 63 consecutive eyes of 63 patients who underwent repeat keratoplasty after a failed penetrating keratoplasty. Group 1 (32 eyes) received MMF orally 1 g twice daily for the first 6 months and then 1 g daily for the next 6 months, and group 2 (31 eyes) received topical 0.03% tacrolimus four times a day for 12 months. All patients were treated with topical and oral corticosteroids postoperatively. The participants were observed closely for signs of graft rejection, and the rates of rejection-free graft survival were calculated and compared between the two groups at postoperative month 12.ResultsThe groups were balanced in patient’s age and risk factors for graft rejection (e.g., original diagnosis, number of previous grafts, and quadrants of corneal vascularization). Endothelial graft rejection occurred in 5 eyes (15.6%) of group 1 and 6 eyes (19.4%) of group 2 (P = 0.75). Irreversible endothelial graft rejection resulting in graft failure occurred in 3 eyes of each group (P = 0.99). The rate of rejection-free graft survival was 84.4% in group 1 and 80.6% in group 2 at postoperative month 12 (P = 0.74).ConclusionTopical 0.03% tacrolimus was as effective as systemic MMF as adjuncts to topical and systemic corticosteroids in reducing endothelial graft rejection with 12 months follow up after repeat keratoplasty. More... »

PAGES

2879-2888

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41433-020-01375-z

DOI

http://dx.doi.org/10.1038/s41433-020-01375-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1134384892

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33414533


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