Presurgical Corticosteroid Treatment Improves Corneal Transplant Survival in Mice

Abstract

Purpose To examine the effects of presurgical corticosteroid treatment for normal-risk penetrating keratoplasty (NRPK), high-risk penetrating keratoplasty (HRPK), and high-risk penetrating keratoplasty plus lensectomy. Methods We used 3 corneal transplantation models (NRPK, HRPK, and high-risk penetrating keratoplasty plus lensectomy). For each model, we tried to compare the effect of corticosteroid treatment according to different timetables as follows: The first trial began with a corticosteroid injection given 2 weeks before the PK and continued until 4 weeks after the PK (group 1). The second trial started with a corticosteroid injection given on the day of the PK and continued for 4 weeks after the PK (group 2). The third trial started with a corticosteroid injection administered on the day of the PK and continued for 8 weeks after the PK (group 3). After harvesting and immunostaining of corneas, graft survival, neovascularization (NV), and lymphangiogenesis (LY) were compared among the groups. A P value <0.05 was considered as being statistically significant. Results With respect to graft survival, group 1 had improved graft survival compared with that of group 3 in the HRPK model (P = 0.025). In all the 3 PK models, groups 2 and 3 demonstrated a similar graft survival (P > 0.05). With respect to NV and LY, in NRPK, group 1 showed less NV than did group 2 (P < 0.001) and group 3 (P = 0.016). In HRPK, group 1 also demonstrated less NV and LY than did group 3 (P = 0.045 and 0.044, respectively). Conclusions The initiation time point of the corticosteroid treatment is important for graft survival. Corticosteroid pretreatment is an effective means to increase graft survival for HRPK and to decrease NV and LY for both NRPK and HRPK.

Glucocorticoids induce corneal allograft tolerance through expansion of monocytic myeloid-derived suppressor cells

“…Thus, our finding favors the notion that early treatment with GCs is important for promotion of allograft survival. 23 Although we did not evaluate the effects of locally applied GCs, it is likely that systemic infusion of GCs is more effective at inducing MDSC expansion in BM, given the level of GCs in BM after systemic versus local administration. Second, our data suggest that monocytic MDSCs might be a potential cellular source for tolerogenic cell therapy in transplantation.…”

Local delivery of corticosteroids in clinical ophthalmology: A review

“…Some have advocated for the use of steroids prior to high‐risk transplantation but this has been variably adopted. A survey of the Bowman's Club (The UK Society of corneal surgeons) found that topical dexamethasone was used in 33%, oral prednisolone by 22% and single dose IV methylprednisolone (IVMP) by 14% …”

Management of high-risk corneal transplantation

“…Kim et al 84 proposed a preoperative use of corticosteroids 2 weeks before the transplantations. They revealed that the pretreatment with corticosteroids decreased the host bed neovascularization in both LR and HR corneal transplantation.…”