Update on the Management of High-Risk Penetrating Keratoplasty

被引：35

作者：

Jabbehdari S. ^{[1
]}

Baradaran-Rafii A. ^{[2
]}

Yazdanpanah G. ^{[1
]}

Hamrah P. ^{[3
]}

Holland E.J. ^{[4
]}

Djalilian A.R. ^{[1
]}

机构：

[1] Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, 60612, IL

[2] Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran

[3] Department of Ophthalmology, Tufts University Medical School, Boston, MA

[4] Cincinnati Eye Institute, University of Cincinnati, Cincinnati, OH

来源：

Current Ophthalmology Reports | 2017年 / 5卷 / 1期

关键词：

Cornea; Graft rejection; High risk; Immunosuppressive drugs; Ocular surface disorder; Penetrating keratoplasty;

D O I：

10.1007/s40135-017-0119-2

中图分类号：

学科分类号：

摘要：

Purpose of Review: In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Recent Findings: Despite the immune privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cell transplantation is employed. Summary: Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents, e.g., tacrolimus, cyclosporine, and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts. © 2017, Springer Science + Business Media New York.

引用

页码：38 / 48

页数：10

共 106 条

[11]

Yamagami S., Miyazaki D., Ono S.J., Dana M.R., Differential chemokine gene expression in corneal transplant rejection, Invest Ophthalmol Vis Sci, 40, pp. 2892-2897, (1999)

[12]

Hamrah P., Yamagami S., Liu Y., Et al., Deletion of the chemokine receptor CCR1 prolongs corneal allograft survival, Invest Ophthalmol Vis Sci, 48, pp. 1228-1236, (2007)

[13]

Maguire M.G., Stark W.J., Gottsch J.D., Et al., Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Collaborative corneal transplantation studies research group, Ophthalmology, 101, pp. 1536-1547, (1994)

[14]

Wilson S.E., Kaufman H.E., Graft failure after penetrating keratoplasty, Surv Ophthalmol, 34, pp. 325-356, (1990)

[15]

Paunicka K.J., Mellon J., Robertson D., Petroll M., Brown J.R., Niederkorn J.Y., Severing corneal nerves in one eye induces sympathetic loss of immune privilege and promotes rejection of future corneal allografts placed in either eye, Am J Transplant, 15, pp. 1490-1501, (2015)

[16]

Bersudsky V., Blum-Hareuveni T., Rehany U., Rumelt S., The profile of repeated corneal transplantation, Ophthalmology, 108, pp. 461-469, (2001)

[17]

Writing Committee for the Cornea Donor Study Research G., Sugar A., Gal R.L., Et al., Factors associated with corneal graft survival in the cornea donor study, JAMA Ophthalmol, 133, pp. 246-254, (2015)

[18]

Sit M., Weisbrod D.J., Naor J., Slomovic A.R., Corneal graft outcome study, Cornea, 20, pp. 129-133, (2001)

[19]

Epstein R.J., Seedor J.A., Dreizen N.G., Et al., Penetrating keratoplasty for herpes simplex keratitis and keratoconus. Allograft rejection and survival, Ophthalmology, 94, pp. 935-944, (1987)

[20]

Barney N.P., Foster C.S., A prospective randomized trial of oral acyclovir after penetrating keratoplasty for herpes simplex keratitis, Cornea, 13, pp. 232-236, (1994)

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