Triple therapy reduces corneal graft rejection after high-risk keratoplasty

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.