Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Oftalmologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802013000100010 |
Resumo: | OBJECTIVE: To analyze the recovery of visual acuity (VA) and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP) treated with intravenous (IV) and topic corticosteroid. METHODS: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. RESULTS: A total of 32 eyes from 32 patients (13 male and 19 female) were included in the study. The mean VA (in number of letters) before rejection was 48 (22 to 88 letters). Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001). Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047). CONCLUSION: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment. |
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Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow upKeratoplasty, penetratingGraft rejectionAdrenal cortex hormonesRisk factorsMethylprednisolone/administration & dosageMethylprednisolone/therapeutic useTreatment outcomeOBJECTIVE: To analyze the recovery of visual acuity (VA) and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP) treated with intravenous (IV) and topic corticosteroid. METHODS: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. RESULTS: A total of 32 eyes from 32 patients (13 male and 19 female) were included in the study. The mean VA (in number of letters) before rejection was 48 (22 to 88 letters). Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001). Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047). CONCLUSION: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment.Sociedade Brasileira de Oftalmologia2013-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802013000100010Revista Brasileira de Oftalmologia v.72 n.1 2013reponame:Revista Brasileira de Oftalmologia (Online)instname:Sociedade Brasileira de Oftalmologia (SBO)instacron:SBO10.1590/S0034-72802013000100010info:eu-repo/semantics/openAccessAbe,Ricardo YujiFreire,Lívia Maria DiasCastro,Rosane SilvestreLira,Rodrigo Pessoa CavalcantiArieta,Carlos Eduardo Leiteeng2013-03-05T00:00:00Zoai:scielo:S0034-72802013000100010Revistahttps://rbo.emnuvens.com.br/rbo/indexhttps://old.scielo.br/oai/scielo-oai.phpsob@sboportal.org.br||rbo@sboportal.org.br1982-85510034-7280opendoar:2013-03-05T00:00Revista Brasileira de Oftalmologia (Online) - Sociedade Brasileira de Oftalmologia (SBO)false |
dc.title.none.fl_str_mv |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up |
title |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up |
spellingShingle |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up Abe,Ricardo Yuji Keratoplasty, penetrating Graft rejection Adrenal cortex hormones Risk factors Methylprednisolone/administration & dosage Methylprednisolone/therapeutic use Treatment outcome |
title_short |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up |
title_full |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up |
title_fullStr |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up |
title_full_unstemmed |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up |
title_sort |
Corneal endothelial rejection after penetrating keratoplasty treated with intravenous and topic corticosteroid: one year follow up |
author |
Abe,Ricardo Yuji |
author_facet |
Abe,Ricardo Yuji Freire,Lívia Maria Dias Castro,Rosane Silvestre Lira,Rodrigo Pessoa Cavalcanti Arieta,Carlos Eduardo Leite |
author_role |
author |
author2 |
Freire,Lívia Maria Dias Castro,Rosane Silvestre Lira,Rodrigo Pessoa Cavalcanti Arieta,Carlos Eduardo Leite |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Abe,Ricardo Yuji Freire,Lívia Maria Dias Castro,Rosane Silvestre Lira,Rodrigo Pessoa Cavalcanti Arieta,Carlos Eduardo Leite |
dc.subject.por.fl_str_mv |
Keratoplasty, penetrating Graft rejection Adrenal cortex hormones Risk factors Methylprednisolone/administration & dosage Methylprednisolone/therapeutic use Treatment outcome |
topic |
Keratoplasty, penetrating Graft rejection Adrenal cortex hormones Risk factors Methylprednisolone/administration & dosage Methylprednisolone/therapeutic use Treatment outcome |
description |
OBJECTIVE: To analyze the recovery of visual acuity (VA) and graft survival after first episode of endothelial rejection in penetrating keratoplasty (PKP) treated with intravenous (IV) and topic corticosteroid. METHODS: Interventional, prospective, non-comparative case series study evolving 32 PKP patients in one year follow up, who presented first episode of corneal endothelial rejection. The patients were submitted to 500 mg IV injection of methylprednisolone in association with topical prednisolone. Main outcome measures included VA recovery and corneal edema regression. Second outcome included new rejections and graft failure. Multivariate analysis techniques were used to estimate rates of graft outcome events and the impact of risk factors. RESULTS: A total of 32 eyes from 32 patients (13 male and 19 female) were included in the study. The mean VA (in number of letters) before rejection was 48 (22 to 88 letters). Patients treated within 7 days or less of initial symptoms had better VA recovery, corneal edema regression and less graft failure (p<0.001). Patients with previous ocular surgery had worse VA recovery and more graft failure (p<0.047). CONCLUSION: The association between the other risk factors and the outcomes did not reach statistical significance in the multivariate model because of the small numbers of patients. Methylprednisolone in association with topical prednisolone is an alternative treatment for graft rejection. Our study showed that patients treated within 7 days of symptoms and no previous anterior segment surgery had better visual outcome and graft survival after treatment. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802013000100010 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802013000100010 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0034-72802013000100010 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Oftalmologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Oftalmologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Oftalmologia v.72 n.1 2013 reponame:Revista Brasileira de Oftalmologia (Online) instname:Sociedade Brasileira de Oftalmologia (SBO) instacron:SBO |
instname_str |
Sociedade Brasileira de Oftalmologia (SBO) |
instacron_str |
SBO |
institution |
SBO |
reponame_str |
Revista Brasileira de Oftalmologia (Online) |
collection |
Revista Brasileira de Oftalmologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Oftalmologia (Online) - Sociedade Brasileira de Oftalmologia (SBO) |
repository.mail.fl_str_mv |
sob@sboportal.org.br||rbo@sboportal.org.br |
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1752122336457261056 |