Our Summary

This research paper is about corneal transplantation, which is the most common type of transplant in the world. The main problem that arises after this transplant is the body’s rejection of the new cornea, especially in eyes that already have blood vessels present, known as “high-risk” eyes. The researchers have found that invisible lymph vessels in the eye play a key role in this rejection.

They believe that blocking the growth of these lymph vessels can help the body accept the new cornea, and not just ignore it. This is because the cells that usually present foreign substances to the immune system (antigen-presenting cells) stay longer in the cornea, leading to changes in these cells. The team also thinks that without the lymph vessels, more cells that can prevent an immune response (Tregs) will develop.

However, the current treatments to stop the growth of lymph vessels only work on vessels that are still growing. Most people who need corneal transplants already have mature blood and lymph vessels in their eyes. Right now, there are no strategies to make these existing vessels shrink, and we don’t know much about how these vessels mature.

So, the researchers aim to figure out how to make the body accept the new cornea when there’s an anti-lymph vessel treatment, as well as develop new ways to shrink the existing lymph vessels. They’re testing methods like photodynamic therapy and diathermy, as well as strategies to destabilize the lining of the lymph vessels.

FAQs

  1. What is the main problem that arises after a corneal transplant?
  2. How do lymph vessels in the eye contribute to the rejection of a new cornea?
  3. What are some of the methods the researchers are testing to shrink existing lymph vessels in the eye?

Doctor’s Tip

A helpful tip a doctor might tell a patient about corneal transplant is to follow all post-operative instructions carefully, including taking prescribed medications as directed and attending all follow-up appointments. It’s important to report any signs of infection or rejection to the doctor immediately, such as redness, pain, or vision changes. Maintaining good eye health and avoiding activities that could potentially damage the new cornea, such as rubbing the eyes or engaging in contact sports, can also help ensure a successful outcome.

Suitable For

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

  1. Keratoconus: a condition where the cornea thins and bulges outwards, causing distorted vision.
  2. Fuchs’ dystrophy: a condition where the inner layer of the cornea deteriorates, leading to cloudy vision.
  3. Corneal scarring: caused by injury, infection, or previous eye surgery, leading to vision impairment.
  4. Corneal ulcers: open sores on the cornea that may not heal properly, leading to vision loss.
  5. Corneal degeneration: age-related changes in the cornea that affect vision.
  6. Corneal swelling: known as corneal edema, which can cause vision distortion and discomfort.
  7. Previous corneal transplant rejection: patients who have had a corneal transplant in the past and experienced rejection may require a second transplant.

Overall, patients with corneal conditions that cannot be corrected with glasses, contact lenses, or other treatments may be recommended for a corneal transplant to improve their vision and quality of life.

Timeline

Before corneal transplant:

  1. Patient is diagnosed with a condition that requires a corneal transplant, such as keratoconus or corneal scarring.
  2. Patient undergoes a series of pre-operative tests and evaluations to determine eligibility for the transplant.
  3. Patient is placed on a waiting list for a suitable donor cornea.

After corneal transplant:

  1. Patient undergoes the corneal transplant surgery, which involves removing the damaged cornea and replacing it with a healthy donor cornea.
  2. Patient is monitored closely in the immediate post-operative period for any signs of complications or rejection.
  3. Patient is prescribed a regimen of anti-rejection medications to prevent the body from rejecting the new cornea.
  4. Patient undergoes regular follow-up appointments to monitor the health of the transplanted cornea and adjust medications as needed.
  5. Patient may experience improvements in vision and quality of life as the new cornea settles and heals.

Overall, the goal of a corneal transplant is to improve the patient’s vision and alleviate symptoms associated with their underlying eye condition. With proper care and monitoring, the majority of patients experience successful outcomes following a corneal transplant.

What to Ask Your Doctor

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

  1. What are the risks and benefits of corneal transplant surgery?
  2. Am I considered a high-risk patient for corneal transplant rejection?
  3. What steps can be taken to reduce the risk of rejection after corneal transplant?
  4. Are there any new treatments or techniques available to prevent rejection of the new cornea?
  5. How will my vision be affected after corneal transplant surgery?
  6. What is the recovery process like after corneal transplant surgery?
  7. Are there any lifestyle changes or precautions I should take after the surgery?
  8. How often will I need to follow up with my doctor after the transplant?
  9. What signs or symptoms should I watch for that may indicate rejection of the new cornea?
  10. Are there any support groups or resources available for patients who have undergone corneal transplant surgery?

Reference

Authors: Bock F, Cursiefen C. Journal: Klin Monbl Augenheilkd. 2017 May;234(5):674-678. doi: 10.1055/s-0043-108248. Epub 2017 May 15. PMID: 28505675