AI Article Synopsis
- The study aimed to evaluate the effectiveness and side effects of immunosuppressants in preventing and treating immune rejection following penetrating keratoplasty (PKP).
- A total of thirty-one studies were reviewed, revealing that the immune rejection rate after PKP can range from 4.9% to 28.9%, with corticosteroids being commonly used for prevention.
- The findings indicate that topical cyclosporine A and FK-506 are effective, with FK-506 showing better results, while systemic immunosuppressants also prove useful for high-risk PKP cases, and corticosteroids are effective for treatment, although adding topical cyclosporine A does not enhance treatment outcomes.
Article Abstract
Objective: To investigate the validity and side-effect of immunosuppressants for preventing and treating of immune rejection after penetrating keratoplasty (PKP).
Methods: Randomized and non-randomized controlled trials of immunosuppressants after PKP were searched from Pubmed, EMbase.com, Cochrane library, CNKI and Wanfang database; methodological quality and meta-analysis were carried out according to Evidence-Based Medicine(EBM).
Results: Thirty-one studies in all were evaluated, of which twenty-three were about the prevention, and nine were about the treatment after PKP. The rate of immune rejection after normal PKP is 4.9%-28.9% when using corticosteroids to prevent immune rejection, especially for long-time use. According to meta-analysis: the effectiveness of local cyclosporine A and local FK-506 in preventing immune rejection after PKP is significant, and FK-506 is more effective than CsA topically; systemic CsA and MMF could effectively prevent immune rejection after high-risk PKP; as far as treating immune rejection, corticosteroid, whether topical or systemic, was effective; however additional topical CsA could not improve the treatment effect.
Conclusion: The use of immunosuppressants such as corticosteroids and CsA whether topical or systemic can effectively prevent the occurrence of immune rejection after high-risk PKP.
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