Posters

Immunosuppression with topical tacrolimus in high-risk corneal grafts

Poster Details

First Author: J.Providência PORTUGAL

Co Author(s):    J. Gil   E. Costa   C. Tavares   A. Rosa   M. Quadrado   J. Neto-Murta     

Abstract Details

Purpose:

There is not a consensus for the ideal immunosuppression regimen for high-risk corneal grafts, when there is a loss of the immune-privileged status and the susceptibility to immunological rejection increases. The aim of this study is to report our results of high-risk corneal grafts managed post-operatively with topical tacrolimus immunosuppression.

Setting:

Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra

Methods:

We retrospectively analyzed consecutive cases of high-risk patients underwenting a corneal graft and following a post-operative immunosuppression regimen with topical tacrolimus 0.2 mg/g. Baseline evaluation included complete clinical and ophthalmological evaluation. We defined high-risk patients when at least one of the following criteria was present: at least two quadrants of stromal neovascularization and history of previous graft rejection. In each follow-up visit best corrected visual acuity (BCVA), corneal clarity, neovascularization or any other evidence of rejection as well as tacrolimus-related side effects were documented. We compared the survival of high-risk grafts with previous grafts in the same group of patients.

Results:

We analyzed 28 eyes (15 corneal grafts managed with topical tacrolimus and 13 controls), mostly males (60%), with a mean age of 61.5 years (24 to 92). In the treatment group, 13 eyes had at least one previously failed graft and 9 had more than two quadrants of corneal neovascularization. During a mean follow-up of 14.6 months (4 to 32 months) the viability of the graft was maintained in 100%, compared to a mean follow-up of 15.86 months (1 to 36) corresponding to the mean failure time of the control group. No adverse reactions related to tacrolimus were documented.

Conclusions:

Topical tacrolimus is an effective and safe immunosuppression therapy for high risk corneal grafts, that in addition to our regular post-operative steroid-based protocol provides an improvement in the graft survival.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a competing company, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company