Randomized comparison of topical XXXX 1% versus @entity11074 0.1% in the first year after descemet membrane endothelial keratoplasty.

@entity32 @entity726 @entity134 @entity11074 @entity12356 @entity230 @entity13189 @entity617
PURPOSE: The aim of this study was to compare the efficacy and side effects of @entity12356 1% versus @entity11074 0.1% after Descemet membrane endothelial keratoplasty (DMEK). METHODS: DMEK recipients used @entity12356 1% for 1 month, and they were randomized to either @entity617 or @entity11074 for months 2 through 12. Dosing was 4 times daily in months 1 to 3, thrice daily in month 4, twice daily in month 5, and once daily in months 6 to 12. The main outcomes were immunologic rejection episodes and intraocular pressure (IOP) elevation (defined as >= 24 mm Hg or >= 10 mm Hg increase over the preoperative baseline level), assessed by the Kaplan-Meier survival analysis. RESULTS: The study included 325 eyes (99% were white, 96% had @entity13189 , and 9% had a previous @entity726 diagnosis). No eyes (0%) assigned to @entity617 versus 2 eyes (1.4%) assigned to @entity11074 experienced a possible (n = 1) or probable (n = 1) rejection episode (P = 0.17). Both rejection episodes resolved successfully with increased topical @entity230 . In the @entity617 arm, a significantly higher proportion exceeded the defined IOP elevation threshold (22% vs. 6%, P = 0.0005), and @entity726 medications were initiated or increased more often (17% vs. 5%, P = 0.0003). The most frequent reasons for discontinuing the assigned intervention were IOP management (n = 13 eyes assigned to @entity617 ) or @entity32 management (n = 3 eyes assigned to @entity11074 ). One-year endothelial cell loss was comparable in both arms (30% vs. 31%, P = 0.50). CONCLUSIONS: DMEK has a remarkably low rejection episode rate (<1% through 1 year), as confirmed in this prospective randomized study. This provides a unique opportunity to reduce postoperative topical corticosteroid strength and thereby reduce the risk of @entity134 -associated complications.
