Intracameral Triamcinolone Acetonide as Treatment for Endothelial Allograft Rejection After Penetrating Keratoplasty

Purpose: Intracameral injection of triamcinolone acetonide as treatment of therapy-resistant endothelial allograft rejection after penetrating keratoplasty is reported. Methods: A 32-year-old patient showed conventional therapy-resistant endothelial allograft rejection 2 months after penetrating keratoplasty. The patient received an intracameral injection of 4 mg in 0.1 mL of triamcinolone acetonide. Preinjection visual acuity was Count fingers at 3 ft, and the graft showed diffuse haze and multiple endothelial rejection lines. Results: Within 2 weeks after injection, marked resolution of the microcystic edema and reversal of the endothelial rejection was noted. Fourteen months after injection, best-corrected Visual acuity was 20/20, and intraocular pressure was 17 mm fig without antiglaucoma therapy. Conclusions: Intracameral injection of triamcinolone acetonide may be an additional treatment modality in the treatment of endothelial allograft rejection when traditional steroid therapies have failed.