Use systemic immunosupression with great caution experts advise

Systemic immunosuppression following corneal transplantation should be administered only under strict medical surveillance, according to specialists speaking at the ESCRS Winter Refractive Surgery Meeting's Cornea Day in Athens, Greece.

Jorge L. Alio, MD commented that patients should be made aware that lifelong immunosuppression is unavoidable in some cases. He emphasized that it is especially important to understand that the elderly are more at risk of severe complications and that it may induce fertility problems in women.

However, according to Nikolaos Papadopoulos, MD, the main danger comes in the form lung aspergillosis, a potentially fatal condition. He cited one case where a 65-year old woman, treated with oral cyclosporine, was found to have the condition after a second graft was rejected. Fortunately, in this case they were able to treat the disease and a third graft was successful.

As an alternative, Dr Papadopoulos suggests that topical immunosupression is a viable alternative to systemic treatment. However Dr Alio disagreed, saying that it is simply not as effective over the long-term and is not able to reach the anterior chamber, adding that he personally prefers to use tacrolimus in a 1% concentration.