Combining systemic mycophenolate mofetil (MMF) with topical tacrolimus (FK506) and corticosteroid eyedrops significantly reduces the risk of corneal graft rejection and improves graft survival rates in patients undergoing high-risk keratoplasty (HRK), compared to using FK506 and corticosteroids alone, according to a study.
The study included 55 patients with HRK, characterized by large grafts (≥9 mm), vascularized corneas, regrafting, or eccentric grafts. Group 1 (n = 25) received the triple therapy regimen, while Group 2 (n = 30), received only topical FK506 and corticosteroids. Patients were followed for an average of 9.6 months.
Graft rejection occurred in 16% of patients in Group 1 compared to 60% in Group 2. Kaplan-Meier analysis found significantly higher rejection-free survival rates (82.5% in Group 1 vs 37.1% in Group 2, P < 0.01). Similarly, clear graft survival was markedly better in Group 1 (83.6%) than in Group 2 (36.7%, P < 0.01). No severe systemic side effects were reported in either group.
Reference
Zhang JY, Yu K, Jiang XY, et al. Efficacy of mycophenolate mofetil combined with topical 0.05% tacrolimus in high-risk keratoplasty: 1-year cohort study. Int J Ophthalmol. 2024;17(12):2229-2235. doi: 10.18240/ijo.2024.12.10. PMID: 39697894; PMCID: PMC11589437.
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