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Abstract
Abstract
An Open Prospective Study for the Use of Rapamycin after High-Risk-Keratoplasty First Results of a Pilot Study
Birnbaum F.1, Reinhard T.2, Sokolowska J.1, Mayer K.1, Reis A.1, Oellerich M.3, Sundmacher R.1
1Eye-Hospital, Heinrich-Heine University, 2Eye Hospital, Albert-Ludwigs-University, Freiburg; 3Center of Internal Medicine, Department of Clinical Chemistry, Georg-August University, Goettingen
Purpose: Until now CSA and MMF are the only available systemic immunosuppressants for patients undergoing high-risk-keratoplasty. Regarding side-effects and individual intolerances the clinical testing of alternative immunosuppressants is desirable. Rapamycin has shown its immunosuppressive potential in the rat keratoplasty model. After kidney-transplantations Rapamycin is part of several immunosuppressive protocols. Aim of this study was to prove the effectiveness and safety of Rapamycin after penetrating high-risk-keratoplasty.
Method: Ten patients undergoing high-risk-keratoplasty were included in this study. Postoperative medication was Fluocortolon 1 mg/kg/d (tapered off within 3 weeks) and Prednisolonacetate eye-drops 5x/d (tapered off within 5 months). Rapamycin was administered orally once daily (blood-trough-level 4-10 ng/ml) for 6 months. Thereafter, it was tapered off within 2 weeks.
Results: Mean follow-up is 148 days. Until now no immune reactions occurred. 8 patients had partly reversible side-effects as hypercholesteremia, furunculosis,