This article is more than 5 years old. Information may no longer be current.
Cessation of postop steroids a risk factor for graft rejection after DSAEK
A study determined that graft rejection complications resulting from Descemet stripping automated endothelial keratoplasty were manageable with prompt diagnosis and treatment.
Of the 353 DSAEK charts reviewed in the study, there were 30 instances (8.5%) of graft rejection. Cases were included if they had at least 3 months of follow-up.
The cessation of postoperative steroid treatment was one of the predominant risk factors for the development of graft rejection in DSAEK (P < .0001). Of the 30 rejections reviewed, 22 (73.3%) were resolved with steroid treatment.
“This finding has prompted us to now routinely maintain our DSAEK patients on low-dose topical steroid and titrate it in instances of steroid response before discontinuing it entirely. While most rejection episodes have favorable outcomes, failures from advanced presentation highlight the importance of prompt recognition and treatment,” the study authors said.
Race was also a risk factor for graft rejection; black patients had a higher risk of rejection than other races (P = .02).
Studies that focus on long-term follow-up will help confirm if DSAEK is a procedure with a lower risk of graft rejection than penetrating keratoplasty, the authors said.