A comparative study of the effect of topical 0.03% tacrolimus plus 1% topical prednisolone with 1% topical prednisolone alone in preventing rejection after penetrating keratoplasty

Immunologic corneal allograft rejection represents one of the main cause for graft failure. This study was conducted to observe and comparing the beneficial effect of topical 0.03% tacrolimus on corneal graft survival. To compare the effect of topical 0.03% tacrolimus plus 1% topical prednisolone with 1% topical prednisolone alone in preventing rejection after PK. 40 patients were randomly allocated into two groups: Group A: patients received 0.03% topical tacrolimus ointment twice daily for a month plus 1% prednisolone acetate eye drops 2 hourly and tapered monthly. Group B: patients received 1% prednisolone acetate eye drop only 2 hourly and tapered monthly. The clinical outcomes were assessed in terms of post-op complications, graft rejection, and visual acuity after 6 months of follow-up.  SPSS software, 20.0 version, IBM, Chicago were used for statistical analysis. Out of 40 patients, 29 (72.5%) were male and 11(27.5%) were female. Type of surgery and continuous suture closure was found to be statistically significant (p-value < 0.05) with post-op visual acuity in both groups. Types of graft rejection were found to be statistically significant (p-value < 0.05) with enucleation transplantation time(hours) in both groups and with secondary glaucoma (p = <0.001) in group A. We conclude that 0.03% topical tacrolimus ointment along with 1% topical prednisolone shows promising results and can be considered as an effective modality for preventing complications like secondary glaucoma, graft rejection, and getting the better visual outcome, where p-value (<0.05) was statistically significant. All patients should be instructed with regards to the reasonable use of topical tacrolimus to avoid any side effects.