Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"


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Abstract
Abstract

Systemic Cyclosporin A (CSA) and Mycophenolat Mofetil (MMF) as Prophylaxis of Immune Reactions after Allogenic High-risk Penetrating Keratoplasty

Sokolovska J.1, Reinhard T.2, Böhringer D.1, Spelsberg H.1, Sundmacher R.1
1Eye Hospital, Heinrich-Heine University, Düsseldorf
2Eye Hospital, Albert-Ludwigs-University, Freiburg

Purpose: Since 1987 485 patients undergoing high-risk penetrating keratoplasty received systemic CSA or MMF. Retrospectively, we evaluated efficacy and safety of these immunosupressives.
Method: 294 patients were treated postoperatively with systemic CSA for 12,5 + 11,5 months and 191 patients with MMF for 8,2 + 3,1 months. There was no statistically significant difference between the groups concerning patient age, patient gender, donor age, donor gender, organ culture period, graft diameter, HLA-matching and follow up period. Indications for surgery were: a history of previous keratoplasty or deep vascularization in 3 or 4 quadrants: 89 in the CSA group/ 90 in the MMF group; severe atopic dermatitis 67/10; limbal stem cell deficiency 103/35, glaucoma induced endothelial failure 30/25; Herpes-simplex-virus or Acanthamoeba keratitis 5/31.
Results: Three years postoperatively 92,2% of the grafts in the CSA group and 83,8% in the MMF group were free from immune reactions (Kaplan and Meier values, log-rank test, p>0,5). Clear graft survival was 85,5% in the CSA group versus 91,2% in the MMF group (Kaplan and Meier values, l


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