Our Summary

Corneal transplantation is a common surgery for those suffering from corneal blindness. Even though there have been improvements in the surgery and our understanding of it, the 15-year survival rate of corneal transplants is only about 50%, which is lower than most other organ transplants. Corticosteroids are the primary medication used to prevent the body from rejecting the new cornea, but their effectiveness is limited.

Recently, research has shown that mesenchymal stromal cells (MSCs) might be a promising new treatment. MSCs have unique regenerative properties and can help the body accept the new cornea, which would reduce the need for corticosteroids and help prevent rejection of the transplant.

This paper reviews existing research on the use of MSCs in corneal transplantation and summarizes the results of clinical trials using MSCs for other organ transplants. The authors also discuss current issues and challenges related to MSC therapies and suggest strategies for making these therapies safer and more effective in clinical transplantation.

FAQs

  1. What is the current survival rate of corneal transplants after 15 years?
  2. What role do mesenchymal stromal cells (MSCs) play in corneal transplantation?
  3. What are the current challenges regarding MSC therapies in clinical transplantation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about corneal transplant is to follow their prescribed medication regimen carefully, especially when it comes to corticosteroids which are the main immunosuppressive regimen used after the surgery. It is important to take these medications as directed to prevent rejection of the transplant and ensure its long-term success. Additionally, patients should maintain regular follow-up appointments with their doctor to monitor the health of their transplanted cornea and make any necessary adjustments to their treatment plan.

Suitable For

Patients who are typically recommended for corneal transplant include those with corneal scarring, corneal ulcers, keratoconus, corneal dystrophies, and corneal degeneration. These conditions can lead to decreased vision or blindness and may require a corneal transplant to restore vision and improve quality of life. Additionally, patients who have experienced corneal trauma or damage from previous surgeries may also be candidates for corneal transplantation.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with corneal blindness or other corneal conditions that cannot be treated with other methods.
  2. Patient undergoes a thorough evaluation by an ophthalmologist to determine if they are a suitable candidate for corneal transplant.
  3. Patient is placed on a waiting list for a suitable donor cornea.
  4. Once a donor cornea becomes available, patient undergoes surgery to remove the damaged or diseased cornea and replace it with the donor cornea.

After corneal transplant:

  1. Patient is monitored closely for any signs of rejection or complications following the surgery.
  2. Patient is prescribed a regimen of corticosteroids and other immunosuppressive medications to prevent rejection of the transplant.
  3. Patient undergoes regular follow-up appointments with their ophthalmologist to monitor the health of the transplant and adjust medications as needed.
  4. Patient may experience improved vision and quality of life following a successful corneal transplant.
  5. Patient may need to continue taking immunosuppressive medications for an extended period of time to prevent rejection of the transplant.

What to Ask Your Doctor

Some questions a patient should ask their doctor about corneal transplant include:

  1. What is the success rate of corneal transplant surgery?
  2. What are the potential risks and complications associated with corneal transplant surgery?
  3. How long is the recovery process after corneal transplant surgery?
  4. Will I need to take immunosuppressive medications after the surgery, and if so, for how long?
  5. What are the chances of rejection of the transplanted cornea, and how is this monitored and managed?
  6. Are there any alternative treatments or therapies that could be considered instead of a corneal transplant?
  7. What is the long-term outlook for my vision after the corneal transplant?
  8. How often will I need to follow up with my doctor after the surgery, and what signs or symptoms should I watch for that may indicate a problem with the transplant?
  9. Are there any lifestyle changes or precautions I should take after the surgery to protect my new cornea?
  10. Are there any clinical trials or new treatments, such as mesenchymal stromal cell therapy, that I should consider for my corneal transplant?

Reference

Authors: Oh JY, Kim E, Yun YI, Lee RH. Journal: Ocul Surf. 2021 Apr;20:185-194. doi: 10.1016/j.jtos.2021.02.002. Epub 2021 Feb 16. PMID: 33607323