Usefulness of topical cyclosporin A following penetrating keratoplasty

We evaluated the effect of topical instillation of 0.05% cyclosporin A in preventing graft rejection following penetrating keratoplasty in 111 eyes. Cyclosporin A was used as early substitute of topical 0.1% betamethasone in 40 eyes. The other group of 71 eyes were treated by topical betamethasone only. Graft rejection developed in 17.5% in the former group and in 9.9% in the latter. Incidence of postoperative glaucoma was 15.0% in the former group and 19.7% in the latter. The difference was not significant (p > 0.05). The overall incidences in the whole series of 111 eyes were: 12.6% for graft rejection, 93.7% for graft transparency and 18.0% for postoperative glaucoma. The findings show that topical cyclosporin A is not superior to topical betamethasone in preventing graft rejection following penetrating keratoplasty. A discrete combined use of both therapeutic regimens promises to be of value in this regard.