Our Summary

This study, called the FANCY trial, investigated whether matching human leukocyte antigens (HLA) - a type of protein in our bodies - between the donor and recipient of a corneal transplant would help prevent the body from rejecting the new cornea. To test this, the researchers randomly assigned some patients to receive a cornea that was HLA-matched and others to receive a cornea that was randomly assigned.

They found that there was not a significant difference in the rate of rejection between the two groups. Around 15.7% of those who received a HLA-matched cornea experienced a rejection, compared to 17% in the group who received a randomly assigned cornea.

However, the researchers cautioned that the overall rejection rate in their study was lower than what is typically seen in patients with corneal transplants, suggesting that their findings might not be applicable to all patients. Therefore, they concluded that more research is needed to determine whether HLA matching is beneficial for corneal transplantation.

FAQs

  1. What is the FANCY trial and what did it investigate?
  2. Did the FANCY trial find a significant difference in rejection rates between HLA-matched corneas and randomly assigned corneas?
  3. What did the researchers suggest about the applicability of their findings to all patients with corneal transplants?

Doctor’s Tip

In general, after a corneal transplant, it is important for patients to follow their doctor’s instructions closely to prevent rejection of the new cornea. This may include taking prescribed medications, attending follow-up appointments, and avoiding activities that could put strain on the eye. It is also important to report any symptoms of infection or rejection, such as redness, pain, or vision changes, to your doctor immediately.

Suitable For

Patients who are typically recommended for a corneal transplant include those with:

  1. Corneal scarring or cloudiness that affects vision
  2. Corneal thinning or irregular shape (such as in keratoconus)
  3. Corneal ulcers that do not respond to medication
  4. Corneal dystrophies or degenerations that cause vision loss
  5. Previous corneal transplant failure
  6. Trauma to the eye resulting in corneal damage
  7. Corneal swelling (such as in Fuchs’ dystrophy) that affects vision

It is important for patients to discuss their individual case with their ophthalmologist to determine if a corneal transplant is the best treatment option for them.

Timeline

Before a corneal transplant, a patient typically experiences vision loss, pain, and discomfort due to a damaged or diseased cornea. They may undergo various tests and evaluations to determine if they are a suitable candidate for a transplant. Once deemed eligible, they are placed on a waiting list for a donor cornea.

After the transplant surgery, the patient will need to follow a strict regimen of eye drops and medications to prevent infection and rejection of the new cornea. They will have regular follow-up appointments with their ophthalmologist to monitor their progress and adjust their medications as needed. It may take several months for the eye to fully heal and for the patient’s vision to improve.

Overall, the goal of a corneal transplant is to restore vision and alleviate pain and discomfort caused by a damaged cornea. It is important for patients to follow their doctor’s instructions closely and attend all follow-up appointments to ensure the success of the transplant.

What to Ask Your Doctor

  1. What is the success rate of corneal transplants in general?
  2. What are the risks and potential complications associated with corneal transplant surgery?
  3. How long is the recovery period after a corneal transplant?
  4. Will I need to take immunosuppressant medications after the surgery?
  5. How often will I need to follow up with my doctor after the procedure?
  6. Are there any specific lifestyle changes I should make after a corneal transplant?
  7. How long do corneal transplants typically last?
  8. What can I expect in terms of visual acuity and clarity after the surgery?
  9. Are there any specific factors in my medical history that may affect the success of a corneal transplant?
  10. Are there any alternative treatments or procedures that I should consider before opting for a corneal transplant?

Reference

Authors: Böhringer D, Grotejohann B, Ihorst G, Reinshagen H, Spierings E, Reinhard T. Journal: Dtsch Arztebl Int. 2018 Apr 13;115(15):259-265. doi: 10.3238/arztebl.2018.0259. PMID: 29735006