Uso de tacrolimus tópico al 0.03% como agente inmunomodulador en queratoplastia de alto riesgo

María Andrea Estévez Flórez; Fernando Yaacov Peña; Fernando Augusto Godin Estrada

doi:10.70313/2718.7446.v18.n4.465

Authors

María Andrea Estévez Flórez Servicio de Oftalmología. Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.
Fernando Yaacov Peña Servicio de Oftalmología. Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.
Fernando Augusto Godin Estrada Servicio de Oftalmología. Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.

DOI:

https://doi.org/10.70313/2718.7446.v18.n4.465

Keywords:

tacrolimus, keratoplasty, graft rejection, cornea, immunosuppression

Abstract

Objective: To evaluate the clinical outcomes of using 0.03% topical tacrolimus as an immunomodulatory agent in patients undergoing high-risk keratoplasty.

Methods: A descriptive, retrospective observational case series study was conducted between May and December 2024 at the Clínica Oftalmológica Colsubsidio (Bogotá, Colombia). The tacrolimus used was a compounding preparation (ILAB Laboratory). Patients with high-risk corneal transplants were included, treated with topical tacrolimus concomitant with 1% prednisolone acetate. Immunological rejection rate, best corrected visual acuity (BCVA), adverse effects, and therapeutic adherence were analyzed. Descriptive bivariate analyses was used to explore associations between clinical variables and outcomes.

Results: Fifteen cases were included. The mean BCVA showed a clinically significant improvement, from 1.98±0.32 logMAR preoperatively to 0.57±0.20 logMAR postoperatively. Adequate adherence to the treatment was 80.0%. The survival of the corneal grafts was 66.7%. It was determined that 60.0% of the total rejection episodes were directly associated with a lack of adherence. Adverse effects such as burning and foreign body sensation were mild and transient, presenting in 40.0% of the cases, with no severe events documented.

Conclusions: 0.03% topical tacrolimus was associated with significant visual recovery in patients with high-risk corneal transplants. The 66.7% graft survival in this very high-risk cohort and the excellent safety profile reinforce its value as an immunosuppressive strategy that mitigates the risk of graft failure. Prospective controlled studies with a larger sample size are required to robustly confirm these findings at a regional level.

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Author Biographies

María Andrea Estévez Flórez, Servicio de Oftalmología. Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.
- Médica cirujana, Residente de Oftalmología.
- Especialización en Oftalmología, Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.
- Correo: mestevezf@unbosque.edu.co
- ORCID: 0000-0002-3341-9073
Fernando Yaacov Peña, Servicio de Oftalmología. Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.
- Oftalmólogo, Especialista en cirugía refractiva, Asesor metodológico y epedemiologico
- Profesor de Epidemiología, Universidad El Bosque, Bogotá, Colombia.
- Correo: fpenam@unbosque.edu.co
- ORCID: 0000-0002-4336-8636
Fernando Augusto Godin Estrada, Servicio de Oftalmología. Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia.
- Médico cirujano, Especialista en oftalmología, Subespecialidad en Córnea y cirugía refractiva, Asesor temático
- Profesor de Córnea, Universidad El Bosque, Bogotá, Colombia.
- Correo: drfernandogodine@gmail.com
- ORCID: 0000-0001-8540-5784

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