Posters

Efficacy and safety of intravenous immunoglobulins in patients with high risk keratoplasties

Poster Details

First Author: L.Ibares Frías SPAIN

Co Author(s):    V. Osuna- Vázquez   H. Donoso Cortes   B. García- Valcárcel   .            

Abstract Details

Purpose:

To establish the efficacy of intravenous immunoglobulins in treating high-risk keratoplasties

Setting:

Hospital General Universitario Gregorio Marañón/ Madrid ( Spain)

Methods:

Retrospective analysis of case series of high risk keratoplasties in immunoglobulin treatment were analysed. Epidemiological data, data related to the cause of performing a keratoplasty, previous surgeries, clinical characteristics and previous treatments were analysed. The main outcomes analysed after treatment with immunoglobulins were: visual acuity, episodes of rejection, recurrence of underlying disease, control of inflammation and complications.

Results:

Six patients, three men and three women were included (mean age 48.66 ± 16.94 years). The causes of the transplant were severe infectious keratitis (two gram-negative microorganisms, two septate filamentous fungi and two herpetic keratitis) resistant to specific treatment based on the antibiogram in cases of bacterial and fungal keratitis and after treatment with antivirals and vaccine in the case of herpes. The indication for immunoglobulin treatment in all cases was deficiency of humoral immunity. The mean duration of immunoglobulin treatment was 24.33 ± 11.14 months with 23.5 ± 15.64 injections. Clinical improvement without disease progression and no recurrence or rejection of the transplant is described in five patients. The treatment failed in a patient who presented 3 rejections and required a new endothelial transplant. No treatment-related side effects were described. Moreover, in five of the patients, immunoglobulins could be withdrawn without recurrences or rejection of the transplant

Conclusions:

Immunoglobulin treatment is a safe and effective alternative for patients with impaired immunity and severe infectious keratitis who require keratoplasty.

Financial Disclosure:

None