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.

Stanislao Porrini, Teramo (Morro d'Oro)

Votazione: Eccellente
After two stem cell transplants for non-Hodgkin lymphoma, I had a cutaneous and a eye rejection, with corneal ulcers in both eyes and a corneal perforation in the left eye.

I underwent 14 operations at other facilitie... Keep on reading this reviews and contacted 8 well-known Italian professors, but all my hope was gone as everybody refused to perform surgery, because of the seriousness of my problem (1/20 in the right eye, nothing in the left: I was almost blind!).

The only one who give me a good advice was a dear doctor who suggest me to talk to Dr. Badalà, because he could perform a Boston Keratoprosthesis, that she considered my only chance to recover a few dioptres.

After the visit, Dr. Badalà proposed me a corneal transplant.

I underwent the transplant on Dec. 4, 2014, in Milan and was followed by Dr. Badalà and his fantastic team.

After surgery, which lasted 3 hours and a half under general anesthesia, I felt as if nothing had happened: no eye pain and no discomfort due to anesthesia.

I give top marks to surgery and clinic! I was discharged after just one night without any problem.

After surgery, for about ten days I did frequent follow ups, than one every 15 days and after that one every month.

Now,while I’m waiting for removing the stitches and reopening eyelids, I’m following the treatment given by Dr. Badalà and I can see the light through the slot left for the dressing!

For me it is a great progress and I thank the only one who took charge of this delicate problem. Besides being an excellent doctor, Dr. Badalà is a person with whom you can speak freely, as you talk with friends, he made me feel at home and he was always available for any explanation.