Prevention and treatment of corneal graft rejection: Current practice patterns (2004)
Prevention and treatment of corneal graft rejection: Current practice patterns (2004)
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DOI：
10.1097/01.ico.0000178731.42187.46
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发表时间：
2006-04-01
期刊：
影响因子：
2.8
通讯作者：
Stulting, RD
中科院分区：
文献类型：
--
作者：
Randleman, JB;Stulting, RD
目的：本研究旨在分析目前的实践模式，在预防和治疗角膜移植排斥反应，并比较这些模式与以前报道的practice.Methods：在2004年1月，一项调查，解决常规术后管理的角膜移植和各种表现的角膜移植排斥反应的治疗被送往角膜协会的成员。在396份调查中，返回并分析了111份（28%）。所有受访者均使用局部皮质类固醇进行常规术后管理和治疗内皮移植物排斥反应。泼尼松龙，品牌或通用形式，用于各种临床情况下的常规管理的37 - 90%和81 - 91%的各种表现的移植物排斥在所有时间点;然而，6个月后，12 - 26%的使用氯替泼诺进行常规管理。对于高风险移植物的常规管理，48%的患者除了泼尼松龙外还使用局部环孢素。与以往的调查相比，使用口服类固醇显着降低了高风险角膜移植的常规管理，和结膜下类固醇的使用减少了管理的移植物transferment.Conclusions：外用泼尼松龙仍然是预防和治疗角膜移植排斥反应的中流砥柱，然而，新的代理商，氯替泼诺和外用环孢素的作用，正在扩大。
Purpose: This study was designed to analyze current practice patterns in the prevention and treatment of corneal graft rejection and to compare these patterns with previously reported practices.Methods: In January 2004, a survey addressing the routine postoperative management of corneal transplants and the treatment of various manifestations of corneal graft rejection was sent to members of The Cornea Society.Results: Of the 396 surveys, 1 1 1 (28%) were returned and analyzed. All respondents used topical corticosteroids for routine postoperative management and treatment of endothelial graft rejection. Prednisolone, in brand or generic form, was used by 37 to 90% for routine management in various clinical scenarios and 81 to 91% for various manifestations of graft rejection at all time points; however, after 6 months, 12 to 26% used loteprednol etabonate for routine management. For routine management of high-risk grafts, 48% used topical cyclosporine in addition to prednisolone. Compared with previous surveys, the use of oral steroids significantly decreased for the routine management of high-risk corneal transplants, and the use of subconjunctival steroids decreased for the management of graft rejection.Conclusions: Topical prednisolone remains the mainstay for the prevention and treatment of corneal graft rejection; however, the role of newer agents, loteprednol etabonate and topical cyclosporine, is expanding.