Effects of topical corticosteroid treatment on chronic corneal allograft dysfunction after penetrating keratoplasty

Qi ZHOU; Hanmin WANG; Yanlong BI; Songyi WU; Hongping CUI

ABSTRACT

BACKGROUND:

Comeal graft endothelial cell density may decline spontaneously at a super-physiological speed after penetrating keratoplasty (PKP),even if no corneal rejection happens,and this is chronic corneal allograff dysfunction (CCAD).

OBJECTIVE:

To investigate the effects of topical corticosteroid treatment on chronic corneal allograft dysfunction after PKP.DESIGN,TIME AND

SETTING:

A controlled clinical analysis was performed at the Department of Ophthalmology,Tongji Hospital,Tongji University from May 2004 to May 2009.

PARTICIPANTS:

A total of 54 patients (eyes) who underwent PKP were included in this study.

METHODS:

Tobramycin-dexamethasone eyedrops was applied 6 times per day as an initial dosage and tapered during 4 months.Thereafter,drug withdrawal group and long term group were randomly divided.Treatments were ceased in the drug withdrawal group but were continued in the long-term group with a dosage of twice per day till 12 months after surgery.MAIN OUTCOME

MEASURES:

Corneal graft endothelial cell density was followed up.The mean follow up pedod was 3.12±0.28years.

RESULTS:

The corneal graft endothelial cell density of drug withdrawal and long term groups was dramatically declined within 36 months after PKP.At every time point,the endothelial cell density was significantly decreased compared to the last follow up (all P＜0.01 ).The endothelial cell density was decreased from (2 428±2.11) cells/mm~2 and (2 791±2.29) cells/mm~2 to (1 424±124) cells/mm~2 and (1 614±114) cells/mm~2 in the drug withdrawal and long-term groups,respectively.There was significant difference in endothelial cell density between the two groups no matter prior to surgery or at each time points after surgery,but the declination trends of two groups were basically the same,indicating that graft loss of endothelial cell density was not impacted by topical corticosteroid treatment after PKP (P＞0.05).

CONCLUSION:

Chronic corneal allograft dysfunction after PKP is independent of topical corticosteroid treatment.