Immunosuppressive therapy for ocular surface disorders

Corticosteroids have been the mainstay of ocular anti-inflammatory therapy. However, in some patients, systemic corticosteroids are insufficient to control the disease, and additional immunosuppressive therapy is required. Many patients need a corticosteroid sparing agent to minimize side effects from long-term use of systemic corticosteroids. In these situations, immunosuppressive drugs play a vital role in the management of severe or refractory ocular surface inflammation as well as limbal stem cell transplantation. An expert panel recently published guidelines for the use of immunosuppressive drugs in the management of ocular inflammation [1]. The goals of this chapter are to assist clinicians in selecting appropriate immunosuppressive drugs for management of severe ocular surface disease, and for prevention of allograft rejection from limbal stem cell transplantation.