Abstract

DO.08.06

Modern immunosuppressive strategies following penetrating keratoplasty

Birnbaum F., Reinhard T.
University Eye Hospital Freiburg

Immune reactions are still the leading cause for graft failure following penetrating keratoplasty, especially in high-risk situations as vascularization of the recipient cornea, graft position close to the limbus or repeat-keratoplasty. Therefore, systemic immunosuppression is administered additionally to the topical immunosuppression with steroids following keratoplasty in most centers in germany. To date, predominantly cyclosporine A (CSA) und mycophenolate mofetil (MMF) are applied. A prospective, randomized multicenter study was performed, which showed that systemic MMF (2x1g over 6 months) is effective in preventing graft rejection following high-risk keratoplasty even in the long run. Due to the considerable side effects of systemic immunosuppression, the development of a potent topical immunomodulating therapy would be desirable. CSA or FK506-eyedrops could be an option or new approaches like subconjunctival drug delivering devices or topically applied antiangiogenic substances.

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