Our Summary

This research paper is about corneal transplants, which are the most common type of tissue transplant. These transplants are usually successful, but over half of them are rejected in high-risk patients. High-risk patients are those with inflamed and vascularized (blood-filled) host beds. As we learn more about the cellular and molecular processes that lead to transplant rejection, we can develop new techniques to help prevent it. This paper reviews those techniques, which include targeting: 1) the growth of blood and lymph vessels in the cornea, 2) cells that present antigens (substances that trigger an immune response), 3) effector and regulatory T cells (types of immune cells), and 4) mesenchymal stem cells (cells with the potential to develop into many different types of cells).

FAQs

  1. What is the success rate of corneal transplants in low-risk recipients?
  2. What are the main factors that can lead to the rejection of a corneal graft?
  3. What are some of the new therapeutic strategies to promote corneal transplant survival?

Doctor’s Tip

One helpful tip a doctor might tell a patient about corneal transplant is to follow all post-operative care instructions carefully to help prevent rejection of the transplant. This may include using prescribed medications, attending follow-up appointments, and avoiding activities that could put strain on the eyes. It is also important to contact your doctor immediately if you experience any signs of infection or rejection, such as redness, pain, or vision changes.

Suitable For

Patients who may be recommended for a corneal transplant include those with corneal scarring, keratoconus, corneal dystrophies, corneal ulcers, and other corneal diseases or injuries that have resulted in significant vision loss or discomfort. Patients with corneal graft failure, recurrent corneal erosions, or corneal thinning disorders may also be candidates for a corneal transplant. Additionally, patients who have not responded to other treatments such as contact lenses, medications, or corneal collagen cross-linking may be considered for a corneal transplant.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with a condition such as keratoconus, Fuchs’ dystrophy, or corneal scarring that requires a corneal transplant.
  2. Patient undergoes a thorough eye examination and evaluation to determine eligibility for a corneal transplant.
  3. Patient is placed on a waiting list for a donor cornea.
  4. Donor cornea is matched to the patient based on factors such as tissue type and size.
  5. Patient undergoes pre-operative consultations and testing to ensure readiness for surgery.

After corneal transplant:

  1. Patient undergoes corneal transplant surgery, which involves removing the damaged cornea and replacing it with the donor cornea.
  2. Patient is monitored closely in the immediate post-operative period for signs of complications such as infection or rejection.
  3. Patient is prescribed medications to prevent rejection of the donor cornea, such as corticosteroids and immunosuppressants.
  4. Patient attends follow-up appointments with their eye doctor to monitor the healing process and check for signs of rejection.
  5. Patient may experience improved vision and reduced symptoms associated with their previous corneal condition.
  6. Patient continues to be monitored for the long-term to ensure the success and longevity of the corneal transplant.

What to Ask Your Doctor

  1. What is the success rate of corneal transplants in patients with my specific condition or risk factors?
  2. What are the potential risks and complications associated with a corneal transplant?
  3. What is the recovery process like after a corneal transplant surgery?
  4. How long will it take for my vision to improve after the surgery?
  5. Will I need to take any medications after the surgery to prevent rejection of the transplant?
  6. Are there any lifestyle changes I should make to improve the success of the transplant?
  7. How often will I need follow-up appointments after the surgery?
  8. What signs or symptoms should I watch for that may indicate rejection of the transplant?
  9. Are there any alternative treatments or therapies that may be beneficial for my specific situation?
  10. What can I do to support the health and longevity of my corneal transplant in the long term?

Reference

Authors: Tahvildari M, Amouzegar A, Foulsham W, Dana R. Journal: Cell Mol Life Sci. 2018 May;75(9):1509-1520. doi: 10.1007/s00018-017-2739-y. Epub 2018 Jan 6. PMID: 29307015