Our Summary

This research paper reviewed existing literature on cases where corneal transplant rejection (when the body’s immune system attacks the transplanted cornea) was linked with immunizations, such as vaccines. They found 23 cases where the rejection of the corneal transplant occurred around the same time as the patient receiving a vaccine, most commonly the flu shot. Most of these patients were women. The good news is that most of the rejections could be managed using intensive steroid therapy to save the transplant. However, the researchers caution that while this reaction is rare, it could be more common than we think because it may not be reported often. They also note that their conclusions are limited by the small number of cases studied and the fact that all the information they had was gathered after the fact. They encourage eye surgeons to document and report any such cases to better understand this risk.

FAQs

  1. What is the relationship between corneal transplant rejection and immunizations?
  2. What treatment was found effective in managing corneal transplant rejections linked to vaccines?
  3. Why do the researchers believe that the reaction of corneal transplant rejection to vaccines may be more common than reported?

Doctor’s Tip

A doctor might advise a patient who has undergone a corneal transplant to notify their healthcare provider if they are planning to receive any vaccinations, especially the flu shot. This information could help prevent potential complications and allow for closer monitoring of the transplant. Additionally, the patient should be vigilant for any signs of rejection, such as increased redness, pain, or vision changes, and seek medical attention promptly if these symptoms occur. Regular follow-up appointments with an eye care provider are also important to monitor the health of the transplanted cornea.

Suitable For

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

  1. Corneal scarring or clouding caused by conditions such as keratoconus, Fuchs’ dystrophy, or corneal injury.
  2. Corneal ulcers that do not respond to medication or other treatments.
  3. Severe corneal thinning or irregularities that affect vision.
  4. Corneal swelling or edema that impairs vision.
  5. Corneal infections that cause significant damage to the cornea.

It is important for patients considering corneal transplant to undergo a thorough evaluation by an ophthalmologist to determine if they are suitable candidates for the procedure. Additionally, patients should be informed of the potential risks and complications associated with corneal transplant, including the risk of rejection and the need for lifelong immunosuppressive therapy.

Timeline

Before Corneal Transplant:

  1. Patient experiences vision problems, such as blurred vision or sensitivity to light.
  2. Patient undergoes a comprehensive eye examination to determine if a corneal transplant is necessary.
  3. Patient is informed about the risks and benefits of the surgery and consents to the procedure.
  4. Patient undergoes pre-operative testing to ensure they are a suitable candidate for the surgery.

After Corneal Transplant:

  1. Patient undergoes the corneal transplant surgery, where a donor cornea is transplanted onto their eye.
  2. Patient is monitored closely for any signs of rejection, such as redness, pain, or decreased vision.
  3. Patient may experience temporary discomfort or blurred vision after the surgery.
  4. Patient follows a strict post-operative care regimen, including using prescribed eye drops and attending follow-up appointments.
  5. Patient gradually experiences improved vision as the transplanted cornea heals and integrates with their eye.
  6. Patient may need to make lifestyle changes, such as avoiding strenuous activities or wearing protective eyewear, to protect the transplanted cornea.
  7. Patient may need to continue regular eye check-ups to monitor the health of the transplanted cornea and prevent rejection.

What to Ask Your Doctor

  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 period after corneal transplant surgery?
  4. What are the signs and symptoms of corneal transplant rejection?
  5. Are there any factors that may increase the risk of corneal transplant rejection?
  6. Can receiving vaccinations, such as the flu shot, increase the risk of corneal transplant rejection?
  7. Are there any specific precautions I should take regarding vaccinations after undergoing a corneal transplant?
  8. How often should I follow up with my eye surgeon after the corneal transplant surgery?
  9. What should I do if I experience any concerning symptoms after receiving a vaccination following corneal transplant surgery?
  10. Are there any lifestyle changes I should consider to reduce the risk of corneal transplant rejection?

Reference

Authors: Lee EH, Li JY. Journal: Cornea. 2022 May 1;41(5):660-663. doi: 10.1097/ICO.0000000000002898. PMID: 34629440