Our Summary

This research is about a unique case where a 48-year-old man suffered a corneal graft rejection in his left eye three weeks after a yellow fever vaccination. The cornea is the clear, front surface of the eye, and a graft is a transplant of this tissue. The rejection was identified through an eye examination, which found inflammation, swelling of the transplanted cornea, and other signs. The man’s right eye was unaffected.

The rejection was successfully treated with a short course of steroids, which are medications often used to reduce inflammation and suppress the immune system.

This is the first reported case where a corneal transplant rejection has been linked with a yellow fever vaccination. Although the yellow fever vaccine is generally safe and effective, this study suggests that there may be more instances of vaccine-related rejections than we know about. Patients and eye doctors should be aware of possible complications from the vaccine that could potentially threaten sight.

FAQs

  1. Can a yellow fever vaccination cause corneal graft rejection?
  2. What symptoms did the patient experience after the yellow fever vaccination?
  3. How was the corneal graft rejection treated in this case?

Doctor’s Tip

A helpful tip a doctor might tell a patient about corneal transplant is to be vigilant about any changes in their eyesight or eye health after receiving any vaccinations, including the yellow fever vaccine. It is important to promptly report any symptoms such as redness, pain, or decreased vision to their healthcare provider to prevent potential complications like graft rejection. Regular follow-up appointments with an ophthalmologist are also recommended to monitor the health of the corneal graft and address any issues promptly.

Suitable For

Patients who are typically recommended for corneal transplant surgery include those with the following conditions:

  1. Corneal scarring: Scarring of the cornea can result from infections, injuries, or previous surgeries, leading to decreased vision and discomfort.

  2. Keratoconus: A progressive condition in which the cornea becomes thin and cone-shaped, causing blurred vision and sensitivity to light.

  3. Fuchs’ dystrophy: A genetic condition in which cells in the cornea’s inner layer deteriorate, leading to swelling, cloudiness, and vision problems.

  4. Corneal edema: Swelling of the cornea due to various causes, such as endothelial cell dysfunction or trauma.

  5. Corneal degeneration: Progressive thinning or weakening of the cornea, leading to visual disturbances and discomfort.

  6. Corneal infections: Severe infections, such as fungal or bacterial keratitis, that do not respond to medications and can result in scarring or perforation of the cornea.

  7. Corneal dystrophies: Inherited conditions that cause abnormal deposits or changes in the cornea, leading to vision problems.

It is important for patients undergoing corneal transplant surgery to follow post-operative care instructions carefully to reduce the risk of complications, such as graft rejection.

Timeline

Before corneal transplant:

  1. Patient has a history of corneal disease or injury that cannot be treated with other methods.
  2. Patient undergoes a thorough evaluation by an ophthalmologist to determine if they are a candidate for corneal transplant.
  3. Patient may undergo various tests and examinations to assess the health of their eyes and the condition of the cornea.
  4. Patient is placed on a waiting list for a suitable corneal donor.
  5. Surgery date is scheduled and patient is informed about the procedure and post-operative care.

After corneal transplant:

  1. Patient undergoes corneal transplant surgery, which may involve replacing part or all of the damaged cornea with healthy donor tissue.
  2. Patient is monitored closely in the immediate post-operative period for any signs of complications or rejection.
  3. Patient may experience some discomfort, blurred vision, and sensitivity to light in the days following surgery.
  4. Patient follows a strict regimen of eye drops and medications to prevent infection and rejection of the transplant.
  5. Patient attends follow-up appointments with their ophthalmologist to monitor the healing process and ensure the success of the transplant.
  6. In some cases, like the one described in the case report, patient may experience graft rejection, which can be treated with systemic and topical steroids.
  7. Patient continues to be monitored regularly for the rest of their life to ensure the health and longevity of the corneal transplant.

What to Ask Your Doctor

  1. Can receiving the yellow fever vaccine increase the risk of corneal graft rejection?
  2. How common is it for patients to experience corneal transplant rejection after receiving a yellow fever vaccine?
  3. What symptoms should I watch out for that may indicate corneal graft rejection after receiving the yellow fever vaccine?
  4. What treatment options are available if I were to experience corneal graft rejection after receiving the yellow fever vaccine?
  5. Are there any precautions I should take before receiving the yellow fever vaccine to reduce the risk of corneal graft rejection?
  6. Should I inform my ophthalmologist about my plans to receive the yellow fever vaccine, and if so, what information should I provide?
  7. Are there any alternative vaccines or vaccination schedules that may be safer for individuals who have undergone corneal transplant surgery?

Reference

Authors: Vignapiano R, Vicchio L, Favuzza E, Cennamo M, Mencucci R. Journal: Ocul Immunol Inflamm. 2022 Jul;30(5):1207-1210. doi: 10.1080/09273948.2020.1870146. Epub 2021 Jan 28. PMID: 33507830