Effectiveness and safety of systemic cyclosporine for high-risk keratoplasty

We reviewed 51 high-risk eyes of 50 patients receiving penetrating keratoplasty. They were given systemic cyclosporine A to prevent immune graft rejection. High risk was defined as the presence of corneal neovascularization in 2 or more quadrants or repeat keratoplasty. During follow-up for an average of 14.9 ± 10.2 months, the graft remained transparent in 37 eyes (73%). Allograft rejection developed in 13 eyes (26%). As temporary side effects, hiccups, abdominal pain, systemic hypertension, mental confusion, and dysuria developed in one patient each. The findings show that systemic cyclosporine A is safe and effective in preventing immune graft rejection if protocol is strictly adhered to.