Our Summary

This study looked at the risk of cornea transplant rejection and failure in adults who had undergone a first cornea transplant for conditions such as keratoconus, pseudophakic bullous keratopathy, or previous infection. Researchers analyzed data from the UK transplant registry from 1999 to 2017. They found that patients with pseudophakic bullous keratopathy were more likely to reject the transplant if their cornea was heavily vascularised (had a lot of blood vessels) before the transplant. Similarly, those who had a transplant due to a previous infection were also more likely to reject the transplant if their cornea was heavily vascularised. However, the presence of blood vessels didn’t increase the risk of transplant failure in any group. The type of transplant also had an effect, with certain types of surgery potentially reducing the risk of rejection and/or failure in vascularised corneas. The findings suggest that the reason for needing a cornea transplant can greatly affect the risk of rejection, particularly if the cornea is heavily vascularised.

FAQs

  1. Does the reason for needing a cornea transplant affect the risk of rejection?
  2. Does the presence of blood vessels in the cornea increase the risk of transplant failure?
  3. How does the type of transplant surgery affect the risk of rejection and/or failure in vascularised corneas?

Doctor’s Tip

One helpful tip a doctor might tell a patient about corneal transplant is to closely follow the prescribed medication regimen, especially in the early post-operative period. This can help prevent rejection and improve the chances of a successful outcome. Additionally, avoiding activities that could put strain on the eye, such as heavy lifting or rubbing the eye, can also help promote healing and reduce the risk of complications. Regular follow-up appointments with your eye care provider are important to monitor the progress of the transplant and address any concerns promptly.

Suitable For

Patients who are typically recommended for a corneal transplant include those with conditions such as keratoconus, pseudophakic bullous keratopathy, or previous infection. Additionally, patients with heavily vascularised corneas may be at a higher risk of rejection, particularly if they have pseudophakic bullous keratopathy or previous infection as the reason for needing a transplant. The type of transplant surgery may also play a role in reducing the risk of rejection and failure in these patients.

Timeline

Before cornea transplant:

  1. Patient is diagnosed with a condition such as keratoconus, pseudophakic bullous keratopathy, or previous infection that requires a cornea transplant.
  2. Patient undergoes pre-operative evaluations and tests to determine eligibility for the transplant.
  3. A suitable donor cornea is identified and the transplant surgery is scheduled.
  4. Patient undergoes the cornea transplant surgery, which involves removing the damaged cornea and replacing it with the donor cornea.

After cornea transplant:

  1. Patient is monitored closely in the immediate post-operative period for any signs of complications or rejection.
  2. Patient is prescribed a regimen of eye drops and medications to prevent infection and rejection of the transplant.
  3. Patient attends regular follow-up appointments with their ophthalmologist to monitor the health and function of the transplanted cornea.
  4. Patient may experience some temporary discomfort, blurred vision, or sensitivity to light in the weeks following the surgery.
  5. Over time, the transplanted cornea gradually heals and the patient’s vision improves.
  6. Patient may need to undergo additional surgeries or procedures in the future to maintain the health of the transplanted cornea.
  7. Long-term follow-up care is essential to monitor for potential complications and ensure the success of the cornea transplant.

What to Ask Your Doctor

  1. What is the reason for needing a cornea transplant in my case?
  2. How likely is it that my cornea transplant will be rejected or fail?
  3. Are there any specific factors in my case, such as the presence of blood vessels in the cornea, that may increase the risk of rejection or failure?
  4. What type of cornea transplant surgery would be most appropriate for my specific condition?
  5. Are there any steps I can take to reduce the risk of rejection or failure after the transplant?
  6. What is the success rate of cornea transplants in patients with a similar condition to mine?
  7. What is the recovery process like after a cornea transplant?
  8. What are the potential complications or side effects of a cornea transplant?
  9. How long will it take for my vision to improve after the transplant?
  10. Are there any lifestyle changes or precautions I should take after the transplant to ensure its success?

Reference

Authors: Sibley D, Hopkinson CL, Tuft SJ, Kaye SB, Larkin DFP; National Health Service Blood and Transplant Ocular Tissue Advisory Group and contributing ophthalmologists (OTAG Study 26). Journal: Br J Ophthalmol. 2020 May;104(5):729-734. doi: 10.1136/bjophthalmol-2019-314200. Epub 2019 Aug 28. PMID: 31462418