Our Summary

This research looked into the occurrence and causes of a condition called corneal decompensation among patients with uveitis, an inflammation of the eye. Uveitis can sometimes lead to corneal decompensation, a serious eye disorder where the clear front surface of the eye (cornea) begins to fail. The researchers reviewed the records of over 4,000 uveitis patients from a Manchester eye clinic between 1991 and 2018 and found that only a small number (0.6%) developed corneal decompensation. In most cases, it took around two years from when uveitis was diagnosed for this to happen.

About 41% of these patients also had glaucoma, a condition that damages the eye’s optic nerve. Half had undergone eye surgery before their cornea started to fail. If there was no history of high eye pressure or eye surgery, the likely cause of corneal decompensation was keratouveitis, a specific type of uveitis that can be linked to an autoimmune disorder or tuberculosis.

Corneal transplants were needed in 41% of the cases, and some of these patients needed more than one transplant. The study concludes that corneal decompensation is a rare but serious complication of uveitis. It’s often linked to previous high eye pressure or eye surgery. The results of corneal transplants in these cases can be less than ideal.

FAQs

  1. What is the prevalence of corneal decompensation in patients with uveitis?
  2. What is the most common cause of corneal decompensation in patients with uveitis who have no history of raised intraocular pressure or intraocular surgery?
  3. What are the outcomes of corneal transplantation in patients with corneal decompensation due to uveitis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about corneal transplant is to follow the post-operative care instructions carefully to ensure the best possible outcome. This may include using prescribed eye drops, avoiding rubbing or touching the eye, and attending follow-up appointments as scheduled. Proper care and monitoring are essential for the success of the transplant surgery.

Suitable For

Patients who are typically recommended for corneal transplant are those with uveitis-related corneal decompensation. In this study, it was found that corneal decompensation in eyes with uveitis is a rare but significant complication. Factors that may lead to corneal decompensation in these patients include direct endothelial inflammation, raised intraocular pressure, and prior intraocular surgery. Patients with uveitis-related corneal decompensation may require corneal grafting, with some patients needing repeat grafting. It is important for healthcare providers to closely monitor these patients and consider corneal transplant as a treatment option to improve visual outcomes.

Timeline

  • Before corneal transplant:
  1. Patient is diagnosed with uveitis.
  2. Patient may develop corneal decompensation, with symptoms such as decreased vision, pain, and sensitivity to light.
  3. Patient may have associated glaucoma.
  4. Patient may undergo intraocular surgery.
  5. Corneal decompensation may be caused by direct endothelial inflammation or other factors such as raised intraocular pressure or prior surgery.
  • After corneal transplant:
  1. Patient undergoes corneal graft surgery.
  2. Patient may require repeat grafting in some cases.
  3. Visual outcomes of corneal transplantation in uveitis-related corneal decompensation cases may be disappointing.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a corneal transplant in my specific case of uveitis-related corneal decompensation?
  2. What is the success rate of corneal transplants in patients with uveitis-related corneal decompensation?
  3. How long is the recovery process after a corneal transplant?
  4. Are there any specific medications or treatments I should be aware of post-transplant to prevent rejection or complications?
  5. What are the alternative treatment options available for uveitis-related corneal decompensation?
  6. How often will I need to follow up with you after the corneal transplant surgery?
  7. Will I need any additional surgeries or treatments in the future for my uveitis-related corneal decompensation?
  8. How can I best care for my eyes and prevent further damage or complications in the future?

Reference

Authors: Wong SW, Carley F, Jones NP. Journal: Ocul Immunol Inflamm. 2021 May 19;29(4):771-775. doi: 10.1080/09273948.2019.1698747. Epub 2020 Jan 6. PMID: 31906778