Efficacy of tacrolimus capsules in patients undergoing high-risk keratoplasty

Abstract

Purpose: To evaluate the efficacy of tacrolimus capsules in patients undergoing high-risk keratoplasty. Methods: 40 high-risk patients who underwent penetrating keratoplasty at The Third Hospital of Hebei Medical University, China  between January 2016 and December 2021 were included in this study. These patients were divided into two groups based on the specific  immunosuppressant administered post-surgery. Twenty patients were administered oral tacrolimus capsules in conjunction with 0.1 % tacrolimus eye drops, constituting the combination with systemic treatment group (group 1), while another twenty patients were solely  administered 0.1 % tacrolimus eye drops, forming the topical treatment group (group 2). The occurrence of rejection, corneal  neovascularization, corneal graft edema and visual acuity were documented in both groups. Results: In comparison to patients in group  2, patients in group 1 exhibited a significant reduction in rejection rate (p < 0.05). Additionally, the average time of neovascularization in  group 1 was delayed and the number of cases was lower (p < 0.05). Furthermore, a smaller proportion of patients in group 1 experienced  corneal graft edema (25 vs 60 %, p < 0.05), while a higher percentage of patients in group 1 demonstrated improved visual acuity (90 vs 60  %, p < 0.05). Conclusion: Concurrent administration of tacrolimus eye drops and capsules orally effectively mitigates anti-rejection  reactions, regulation of neovascularization, management of graft edema and enhancement of visual acuity in high-risk keratoplasty  patients when compared to the use of tacrolimus eye drops as a standalone treatment. These results have the potential to stimulate  novel avenues of investigation in future clinical research.