Resumen de Immunosuppression with mycophenolate mofetil after penetrating keratoplasty: our clinical experience
M. Hurtado-Sarrió, Antonio Duch Samper, Á. Cisneros Lanuza, Francisco Javier Arteaga Moreno, José Luis Menezo Rozalen, Manuel Díaz Llopis
PURPOSE: Graft prognosis after penetrating high-risk keratoplasty has improved considerably with the use of systemic immunosuppressive medications. In this clinical study, we analyzed the efficacy and safety of Mycophenolate mofetil (MMF) in preventing corneal graft rejection.
METHODS: A total of 99 keratoplasties were analyzed prospectively along 32 months: 59 cases received systemic immunosuppression with Mycophenolate mofetil (MMF) at a daily dose of 2 g, scheduled for 12 to 24 months. A control group of 40 cases did not received systemic immunosuppression. Every patient was treated with topical antibiotics (ciprofloxacin) and topical corticosteroids (prednisone). Metrical data of treated and nontreated groups are compared using chi-square test and logistic-regression analysis.
RESULTS: The percentage of graft rejection was 22,5% in the non MMF group, and 11,86% in the MMF group. The MMF-treated patients showed few side effects and they were reversible. Logistic regression analysis revealed that MMF reduces the probability of graft rejection at 77,72% in any level of risk (adjusted odds ratio 0,22, P=0.02280).
CONCLUSION: We found a significant effect of MMF in preventing immune reaction, mainly after high-risk keratoplasty. Despite a shorter MMF administration compared with other systemic immunosuppressants like cyclosporine A (CsA), it was shown to have comparable potency regarding clear graft survival and good tolerancy
