全層角膜移植後のシクロスポリン点眼の有用性

Usefulness of topical cyclosporin A following penetrating keratoplasty

　全層角膜移植を受けた111眼について，0.05％シクロスポリン点眼と0.1％ペタメタゾン点眼の効果を比較検討した。40眼には早期からシクロスポリン点眼のみを行い，他の71眼にはベタメタゾン点眼のみを行った。移植片の拒絶反応は，前者で17.5％，後者で9.9％に生じた。術後緑内障は，前者で15.0％，後者で19.7％に生じたが，有意差はなかった。111眼全体について，拒絶反応発生率は12.6％，角膜透明治癒率は93.7％，術後緑内障の発生率は18.0％であった。以上の結果から，シクロスポリン点眼がベタメタゾン点眼よりも優れているとはいえないことが結論された。両者の組み合わせで，成績を向上させる可能性がある。

We evaluated the effect of topical instillation of 0.05% cyclosporin A in preventing graft rejection following penetrating keratoplasty in 111 eyes. Cyclosporin A was used as early substitute of topical 0.1% betamethasone in 40 eyes. The other group of 71 eyes were treated by topical betamethasone only. Graft rejection developed in 17.5% in the former group and in 9.9% in the latter. Incidence of postoperative glaucoma was 15.0% in the former group and 19.7% in the latter. The difference was not significant (p＞0.05) . The overall incidences in the whole series of 111 eyes were : 12.6% for graft rejection, 93.7% for graft transparency and 18.0% for postoperative glaucoma. The findings show that topical cyclosporin A is not superior to topical betamethasone in preventing graft rejection following penetrating keratoplasty. A discrete combined use of both therapeutic regimens promises to be of value in this regard.