Calcineurin inhibitor in corneal transplantation

Objective: To evaluate the long-term efficacy and safety of topical calcineurin inhibitor, tacrolimus 0.003% suspension for the management of steroid-induced ocular hypertension post-penetrating keratoplasty [PK]

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Design: A Retrospective Study

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Setting: Magrabi Aseer Eye Hospital, Khamis Mushait, Saudi Arabia

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Method: Twenty primary keratoplasties [primary PK] performed between 1 January 2012 and 31 December 2015 were included in the study. Prednisolone was replaced with tacrolimus 0.003% suspension after intraocular pressure [IOP] elevation. Primary outcome measure was immunologic graft rejection episodes and secondary outcome measures were pre and postoperative best-corrected visual acuity [BCVA]

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Result: Twenty patients with keratoconus were included in the study; 12 [60%] were males and the mean age was 27 years

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There were no reports of graft rejection or patients requiring glaucoma surgery

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Tacrolimus was well tolerated; however, all patients reported a mild transient burning sensation in the eye during application. At the final follow-up, tacrolimus was tapered for all patients

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Conclusion: Topical tacrolimus 0.003% suspension is an effective second-line immunosuppressant for the management of primary, normal-risk corneal grafts in patients who are steroid responders