Background: To investigate the outcome and prognostic factors for corneal graft recovery after severe corneal\r\ngraft rejection following penetrating keratoplasty (PKP) treated with topical and systemic steroids.\r\nMethods: Fifty-eight eyes in 58 patients with severe corneal graft rejection following PKP were treated with topical\r\nand systemic steroids. Factors affecting the reversibility and maintenance of graft transparency were analyzed.\r\nResults: Graft transparency was restored in 37 of 58 eyes (63.8%). Clarity of the graft was maintained in 25 of 37\r\neyes after transparency was restored, while corneal decompensation developed at a mean of 6.0 Ã?± 4.3 months in\r\nthe remainder. The interval between rejection and treatment with systemic steroids was shorter in cases that\r\nrecovered graft transparency (OR, 0.88, 95% CI. 0.80ââ?¬â??0.97, P = 0.0093). Corneal decompensation after the recovery of\r\ncorneal transparency tend to occur in cases of regraft (OR, 0.09, 95% CI. 0.01ââ?¬â??0.54, P = 0.0091).\r\nConclusions: Severe corneal graft rejection after PKP was reversible in approximately two-thirds of the cases, with\r\ngraft transparency being maintained in two-thirds of them when treated with both topical and systemic steroids.\r\nEarly treatment confers a benefit in terms of the recovery of graft transparency.
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