穿透性角膜移植术后环胞霉素A与皮质类固醇的合理应用

Topical application of cyclosporin A and corticosteroid in penetrating keratoplasty

对穿透性角膜移植术后患者合理应用环胞霉素Ａ滴眼液代替地塞米松滴眼液的疗效和眼压进行评价。方法：４２０例穿透性角膜移植术后患者，随机分成两组。Ａ组：０．５％地塞米松滴眼液联合１％环胞霉素Ａ滴眼液，每天４次，共３个月。Ｂ组：０．５％地塞米松滴眼液联合１％环胞霉素Ａ滴眼液，每天４次，共１个月，后改用１％环胞霉素Ａ滴眼液至３个月。对两组眼压和免疫排斥情况进行观察。结果：Ａ组５８例患者眼压＞２２ｍｍＨｇ，占２５％；Ｂ组９例眼压＞２２ｍｍＨｇ，占５％。两组眼压统计（Ｐ＜０．００１），有非常显著性差异。停用０．５％地塞米松滴眼液后，１～２周大部分患者眼压降至正常。两组免疫排斥反应率无差异。

To evaluate the effects of cyclosporin A eye drop substituting dexamethasone eye drop properly to prevent allograft rejection after penetrating keratoplasty.Methods:420 cases of penetrating keratoplasty were divided into 2 groups.In group A, 0 5% dexamethasone eye drop combining with 1% cyclosporin A eye drop were given 4 times daily for 3 months.In group B,0 5% dexamethasone eye drop combining with 1% cyclosporin A eye drop were given 4 times daily for 1 month,and then 1% cyclosporin A eye drop was applied alone in the following 2 months.Intraocular pressures and graft fates of them were followed up.Results:In group A, IOPs were higher than 22mmHg in 58(25%)cases,while there were only 9 cases(5%)in group B whose IOPs were higher than 22mmHg.There was highly significant difference (P<0 001)between them.When we stop the 0 5% dexamethasone eye drop,most of the high IOPs fall down to the normal range in 1 2 weeks.There was no significant difference in the occurrence of graft rejecting between 2 groups.Conclusion:1% cyclosporin A eye drop can substitute the corticosteroid eye drop to prevent the occurrence of graft rejection and corticosteroid glaucoma.