But To evaluate cyclosporine A (CsA) 2 % eye-drops in the prevention of acute rejection after penetrating keratoplasty (PKP) in patients with severe ocular rosacea. Objectifs and Methods IRB approval (Poitiers School of Medicine) was given an Informed Consent was obtained from all patients according to French Regulations. 35 patients with severe Rosacea that underwent a PKP from 2000 to 2003 for pseudophakic bullous keratopathy were topically treated with CsA2%. The patient's charts, the level of rejection risk, the IOP and the graft outcome were analyzed. Results No systemic effect was detected. 21 rejections developed after a median of 18.5 months. Ten rejections under CsA 2% treatment were reversible. Discussion In addition to chronic ocular surface inflammation, patients with severe ocular rosacea often present with new-vessels in multiple quadrants. These ones do contribute greatly to the acute rejection process. CsA 2% showed no beneficial effect on these new-vessels. Conclusion CsA 2% eye-drops failed in being an effective treatment in the prevention of acute rejection in patients with severe ocular rosacea.