Corneal Transplant: rejection and other risks

Corneal transplant rejection

Major risks after corneal transplant are related to rejection. There is always a risk of rejection after corneal transplant: it is usually higher right after surgery and lowers over time.

Symptoms of rejection can be as light as a simple redness of the eye: even this should never be underestimated in patients that have undergone corneal transplant, especially if such symptoms persist for a few days. In these cases the best thing to do is to consult an ophthalmologist. Other symptoms could be photophobia (intolerance to visual perception of light) or vision obfuscation.

Rejection treatment have to start as soon as possible in order to have more chances of success; it is usually based on cortisone eye drops. After surgery, it is important to avoid any eye trauma, at least for the first months.

Surgery lasts about 60-90 minutes: patients leave the operating room with bandages that are removed the following day. Post-op duration after this surgery may vary depending on the kind of transplant (traditional, lamellar or artificial like the Boston Keratoprosthesis). In case of traditional corneal transplant, post-op lasts a few months.

In case of anterior lamellar corneal tranplant (DALK), post-op lasts for a few weeks; same goes for the endothelial corneal transplant (DSAEK). The Boston Keratoprosthesis post-op takes up only a few days.

What are the risks for corneal transplant?

Major risks for this tranplant belong to two categories: the ones that may occur during surgery and the ones that may occur after.

Intraoperative risks can be pretty serious in case of traditional corneal transplant, where the whole cornea is subtituted: the eye remains open with no protection during the process.

In this very phase, it may occur a serious complication called expulsive hemorrhage; anyway it is a rare complication that may happen in case of a full-depth corneal transplant. There is no report of this complication in case of lamellar corneal transplant.

Risks after corneal transplant surgery are mainly related to rejection. There is always a risk of rejection in case of corneal transplant but it is important to remember that this kind of transplant holds the higher success rate of every other organ transplant.

With lamellar transplant like DALK (in depth anterior lamellar keratoplastic) or DSAEK (endothelial corneal transplant), there is a lower risk of rejection because the portion of transplanted cornea is smaller.
Rejection treatment is based upon cortisone eye drops that may result in collateral effects such as cataract or glaucoma; with lamellar trasplant, rejection treatment is quicker.

Gianna Lo Castro, Siracusa (Lentini)

Votazione: Eccellente
A few years ago I discovered I had a quite rare disease called "Fuchs' dystrophy," which affects the cornea.

I had troubles driving and was always seeing through the fog. The fog was getting worse and worse, making it... Keep on reading this review difficult to distinguish different objects. I had great difficulty, even to watch TV.

I was considering myself on the way to blindness and was wondering how could I deal with my new "low vision status".  I did not give up and started looking around!

I finally found a specialist using cutting edge technology: Dr Badala. He explained me my condition and reassured me! Then he proposed a new corneal endothelium transplant called  DMEK. I finally decided and underwent surgery.

I faced some difficulties, like lying down supine for about 48 hours, but it was worth it! Now my low vision is just a memory!

I started to see immediately: everything was clear! I could even make out the pictures on TV! Coming back home, I saw my cat with its true colors in contrast: black and white, rather than an indefinite gray as before surgery !! So? !! ... Thanks a lot  Dr. Badalà!