Research Article Open Access

Topical Cyclosporine A in Corneal Graft Rejection

Mahmood Nejabat1, Jafar Khoshghadam1, Masoomeh Eghtedari1 and Hamid Hosseini1
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American Journal of Immunology
Volume 2 No. 2, 2006, 29-34


Submitted On: 28 March 2006 Published On: 30 June 2006

How to Cite: Nejabat, M., Khoshghadam, J., Eghtedari, M. & Hosseini, H. (2006). Topical Cyclosporine A in Corneal Graft Rejection. American Journal of Immunology, 2(2), 29-34.


Corneal graft rejection is now the most common cause of graft failure after penetrating keratoplasty. This study was designed to determine whether, addition of 2% topical cyclosporine (CSA) to local and systemic steroids in treatment of endothelial corneal allograft rejection, would improve the outcome. A prospective randomized treatment trial was carried out on 40 consecutive corneal graft recipients, presenting with the first episode of endothelial graft rejection in two groups. Group one (20 patients) received topical steroids eye drops and systemic prednisolone (1 mg/kg) by oral route plus placebo. Group two (20 patients) received the same topical and systemic steroid therapy plus 2% cyclosporine A (CSA) eye drop. The patients were followed up for three months and their clinical outcomes were evaluated by the rates and time of rejection reversal. In group one, 14 (70%) cases had total reversal of graft rejection episode but in CSA group, it occurred in 18 (90%) cases (P=0.21) .Improvement were started within a mean period of 3 and 1.5 days respectively (P value<0.001). Among patients who sought treatment early (<6 days), the survival rates were 85% and 100% respectively (P=0.2). In high risk patients the rejection reversal rate was 66% in CSA group and 25% in the control group (P=0.5). Our study indicates addition of 2% CSA eye drop to topical and systemic steroids in graft rejection decreases the interval between treatment intervention and improvement of clinical signs. In high risk patients it may improve the reversal rate, however it needs further studies.

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  • Cyclosporine A
  • Graft rejection
  • Penetrating keratoplasty