Our Summary

This study looked at whether matching certain proteins (HLA Class II antigens) between a donor and recipient could reduce the risk of the recipient’s immune system rejecting a cornea transplant. The researchers matched these proteins as well as HLA Class I antigens and followed 1133 patients for 5 years.

However, they found that matching HLA Class II antigens did not make a difference in terms of rejection. They also found that older patients (over 60) were less likely to reject the transplant, while younger ones (40 or less) were more likely to experience rejection.

Additionally, those who had undergone cataract surgery after the cornea transplant were more likely to have a rejection. The presence of other pre-existing conditions also increased the risk of rejection, but no single condition was identified as a significant risk factor on its own. However, having two or more of these conditions was more likely to result in rejection.

In other words, the study suggests that matching these specific proteins doesn’t necessarily help prevent the body from rejecting a new cornea. Other factors, like age, additional surgeries, and pre-existing conditions, play a more significant role.

FAQs

  1. Does matching HLA Class II antigens between a donor and recipient reduce the risk of cornea transplant rejection?
  2. What factors were found to increase the likelihood of cornea transplant rejection?
  3. How does age impact the likelihood of cornea transplant rejection?

Doctor’s Tip

Therefore, it is important for patients undergoing a corneal transplant to be aware of these potential risk factors and to closely follow their doctor’s post-operative care instructions. Regular follow-up visits with your eye care provider are essential to monitor the health of the transplanted cornea and catch any signs of rejection early on. It is also important to maintain a healthy lifestyle and take any prescribed medications as directed to help reduce the risk of rejection. If you have any concerns or notice any changes in your vision after a corneal transplant, be sure to contact your doctor right away.

Suitable For

Patients who are typically recommended for corneal transplant are those who have:

  1. Corneal scarring or damage due to infections, injuries, or diseases such as keratoconus
  2. Corneal thinning (keratoconus)
  3. Fuchs’ dystrophy
  4. Corneal ulcers that do not respond to medication
  5. Corneal swelling (bullous keratopathy)
  6. Corneal clouding or opacity (due to genetic conditions or previous surgeries)
  7. Corneal degeneration or dystrophies
  8. Corneal scarring due to previous surgeries or trauma

It is important to note that each patient is unique, and the decision to undergo a corneal transplant is based on individual circumstances and the recommendation of an ophthalmologist or corneal specialist.

Timeline

Before the corneal transplant:

  • Patient will undergo a thorough eye examination to determine if a corneal transplant is necessary
  • Patient will be placed on a waiting list for a suitable donor cornea
  • Once a donor cornea is available, surgery will be scheduled
  • Patient will receive pre-operative instructions and will need to undergo various medical tests
  • Surgery will be performed, and patient will be closely monitored for any complications or signs of rejection

After the corneal transplant:

  • Patient will need to use eye drops and medications to prevent infection and rejection
  • Patient will have regular follow-up appointments to monitor the healing process and check for signs of rejection
  • Patient may experience temporary vision changes, discomfort, and sensitivity to light
  • It may take several months for the vision to fully stabilize and improve
  • Patient will need to follow a strict post-operative care routine to ensure the success of the transplant
  • In some cases, additional surgeries or treatments may be needed to address complications or rejection episodes

What to Ask Your Doctor

  1. What is the success rate of corneal transplants in general, and what factors can affect the outcome of the surgery?

  2. Is matching HLA Class II antigens between the donor and recipient important for reducing the risk of rejection, based on the findings of this study?

  3. How does age play a role in the likelihood of rejection after a corneal transplant, and why are younger patients more at risk?

  4. Can undergoing cataract surgery after a cornea transplant increase the risk of rejection, and if so, why?

  5. What pre-existing conditions might increase the risk of rejection after a corneal transplant, and how can they be managed?

  6. Are there any specific precautions or follow-up care that I should take after undergoing a corneal transplant to reduce the risk of rejection?

  7. What are the signs and symptoms of rejection that I should watch out for after the surgery, and when should I contact my doctor if I suspect rejection?

  8. Are there any lifestyle changes or medications that can help prevent rejection and promote the success of the corneal transplant?

  9. How often should I have follow-up appointments with my doctor to monitor the health of my new cornea and assess the risk of rejection?

  10. Are there any alternative treatments or options available if rejection occurs, and what are the potential risks and benefits of these alternatives?

Reference

Authors: Armitage WJ, Winton HL, Jones MNA, Downward L, Crewe JM, Rogers CA, Tole DM, Dick AD. Journal: Br J Ophthalmol. 2022 Jan;106(1):42-46. doi: 10.1136/bjophthalmol-2020-317543. Epub 2020 Dec 2. PMID: 33268345