Document Detail


Case-control study of subconjunctival triamcinolone acetonide injection vs intravenous methylprednisolone pulse in the treatment of endothelial corneal allograft rejection.
MedLine Citation:
PMID:  18820657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the safety and effectiveness of treating corneal endothelial rejection with a subconjunctival injection of 20 mg triamcinolone acetonide in combination with topical application of 1% prednisolone acetate, as compared to treatment with an intravenous pulse of 500 mg methylprednisolone in combination with topical application of 1% prednisolone acetate. METHODS: A case-controlled study including a literature review was performed. Patients who presented with an initial episode of corneal endothelial rejection were treated with subconjunctival injection of 20 mg triamcinolone in combination with topically applied 1% prednisolone and were retrospectively matched for age and diagnosis to patients who received a single intravenous injection of 500 mg methylprednisolone in combination with topical 1% prednisolone. Patients were analysed regarding reversion of the rejection episode, intraocular pressure, and visual acuity after 1 year. RESULTS: Overall, the triamcinolone group had a better outcome regarding reversion of corneal transplant rejection (P=0.025), with 15 of 16 patients in the triamcinolone group having clear grafts, compared to only 10 of 16 patients in the methylprednisolone group. Intraocular pressure (IOP) was increased in both groups at day 30 (P=0.002), although there was no statistically significant difference in IOP between the groups (P=0.433). Visual acuity improved in both groups after 1 year (P=0.049), although slightly more improvement was observed in the triamcinolone group (P=0.002). CONCLUSIONS: The results observed in this case-controlled study suggest that the use of subconjunctival triamcinolone acetonide may benefit patients with corneal transplant rejection.
Authors:
D C Costa; R S de Castro; N Kara-Jose
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article     Date:  2008-09-26
Journal Detail:
Title:  Eye (London, England)     Volume:  23     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-16     Completed Date:  2010-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  708-14     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology and Otolaryngology, School of Medical Sciences, State University of Campinas, Campinas, S??o Paulo, Brazil. daciocosta@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Corneal Transplantation*
Drug Therapy, Combination
Follow-Up Studies
Glucocorticoids / administration & dosage
Graft Rejection / drug therapy*
Humans
Injections, Intraocular
Injections, Intravenous
Intraocular Pressure / drug effects
Methylprednisolone / administration & dosage*,  therapeutic use
Prednisolone / administration & dosage,  analogs & derivatives
Treatment Outcome
Triamcinolone Acetonide / administration & dosage*,  therapeutic use
Visual Acuity / drug effects
Chemical
Reg. No./Substance:
0/Glucocorticoids; 50-24-8/Prednisolone; 52-21-1/prednisolone acetate; 76-25-5/Triamcinolone Acetonide; 83-43-2/Methylprednisolone
Comments/Corrections
Comment In:
Eye (Lond). 2009 Mar;23(3):744-5   [PMID:  19098708 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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