Abstract

ARENAS, E; NAVARRO, M  and  MIETH, MA. Intracorneal depot steroids for the treatment of corneal rejection after keratoplasty. Arch Soc Esp Oftalmol [online]. 2004, vol.79, n.2, pp.75-79. ISSN 0365-6691.

Purpose: To introduce a new type of therapy for corneal rejection after keratoplasty with the microinjection of intrastromal depot cortisone in single or multiple doses. Methods: Thirty-three consecutive eyes with corneal graft rejection were diagnosed and treated by one of the authors (EA) between January 1998 and November 2000. Results: Of the 33 eyes, 26 were submitted to Penetrating Keratoplasty (PK), five to lamellar, and two to homoplastic keratoplasty. The most common rejection type was epithelial in 20 eyes, 11 eyes showed mixed rejection types and two eyes, endothelial. In 18 of the cases (54.54%) treatment consisted solely of intraestromal injection; in the other 15 cases some other medications were added mostly because of patient anxiety. The vast majority of the cases (81%) improved clinically within a few days after the injection. Fifty-four percent of the cases required a number of doses ranging from one to five; the rest of the cases had a greater number of sessions. Thirty-one cases have been followed up for a period longer than six months without showing increase in intraocular pressure or development of steroid lens opacities. Conclusion: Intrastromal depot cortisone injection is a new alternative for the treatment of corneal graft rejections after keratoplasty.

Keywords : Intrastromal injection; penetrating keratoplasty; lamellar keratoplasty; homoplastic keratoplasty; graft rejection; depot cortisone.