Management of Corneal Graft Rejection – A Case Series Report and Review of the Literature

Purpose: To report long-term results in a case series of patients treated with systemic immune suppression for prevention of penetrating keratoplasty (PKP) graft rejection. Design: Retrospective noncomparative chart review. Participants: Three patients presented with PKP graft failure. Methods: Patients received oral prednisone, azathioprine and cyclosporine to prevent rejection of repeat corneal transplant. Patients received repeat PKP and graft outcome was reported. Main outcome measures: Visual acuity and graft survival were recorded. Results: Mean age was 55 years, two male and one female. Mean follow-up period was 37 months (range 24- 46). All three patients completed the treatment protocol with minimal adverse effects. All grafts remained clear over observational period. Conclusion: Our study suggests that systemic immune suppression with 2 or more agents may be helpful to prevent corneal graft rejection in high-risk patients.