Effects of subconjunctival ranibizumab in a presensitized rat model of corneal graft

We evaluated whether corneal graft survival in presensitized corneal transplantation was affected by subconjunctival ranibizumab in a rat model. The effect of ranibizumab in the presensitized corneal transplantation has not been previously reported, although anti-VEGF was attempted on a non-presensitized model in other studies. Corneas were transplanted from Brown Norway to Spraque Dawley rats. The recipient rats were randomly assigned to three groups: Group 1, skin autograft and subconjunctival injection of PBS; Group 2, skin allograft and injection of PBS; and Group 3, skin allograft and injection of ranibizumab (vascular endothelial growth factor antibody). A skin graft was performed 2 weeks before corneal transplantation. On days 3, 7, 11, and 14 after transplantation, the grafts were scored. The number of corneas with graft rejection on day 14 was significantly higher in Group 2 than in Group 1 or 3 (6/15 [40.0%] in Group 1, 13/15 [86.7%] in Group 2, and 4/15 [26.7%] in Group 3). The mean clinical scores for edema, opacity, and new vessels in Group 3 were significantly lower than those in Group 2, while the edema score in Group 1 was significantly lower than that in Group 2 on day 14. Before corneal allotransplantation, presensitization by skin grafting accelerated the graft rejection process. In a short-term presensitized rat model of keratoplasty, application of subconjunctival ranibizumab prevented graft rejection.

► Presensitization by skin grafting before corneal allotransplantation accelerated the graft rejection. ► Allosensitization was important in a rat model of corneal transplantation. ► In a short-term presensitized rat model of keratoplasty, application of subconjunctival ranibizumab prevented graft rejection.