Our Summary

A 28-year-old woman who had a successful laser eye surgery (FLEK) started having eye issues including pain, redness, and blurred vision in her left eye two weeks after getting the AstraZeneca COVID-19 vaccine. Doctors found swelling and other signs of rejection in the cornea transplant she received during the surgery. She was diagnosed with acute corneal graft rejection, a condition where the body’s immune system attacks the new cornea. She was prescribed steroids and other medication, which she responded well to. After five weeks of treatment, her vision improved significantly. This case suggests that the COVID-19 vaccine may cause the body to reject cornea transplants, indicating a need to increase the use of steroids before vaccination.

FAQs

  1. Can the AstraZeneca COVID-19 vaccine cause the body to reject cornea transplants?
  2. What is acute corneal graft rejection and how is it treated?
  3. Is there a need to increase the use of steroids before vaccination for cornea transplant patients?

Doctor’s Tip

A doctor may advise a patient who has had a corneal transplant to be aware of the potential risks of rejection, especially after receiving a COVID-19 vaccine. They may recommend closely monitoring any changes in vision, pain, or redness in the eye and seeking medical attention promptly if any symptoms arise. Additionally, the doctor may suggest discussing the possibility of pre-vaccination steroid treatment with their healthcare provider to potentially reduce the risk of rejection. It is important for patients to stay informed and proactive in managing their eye health after a corneal transplant.

Suitable For

Patients who may be recommended for a corneal transplant include those with:

  1. Keratoconus: a progressive eye disease that causes the cornea to become thin and bulge outward, leading to distorted vision.
  2. Corneal scarring: caused by injury, infection, or previous eye surgery, resulting in impaired vision.
  3. Fuchs’ dystrophy: a genetic disorder that causes the cells of the cornea to gradually deteriorate, leading to vision problems.
  4. Corneal ectasia: a condition where the cornea becomes weak and bulges outward, often as a complication of laser eye surgery.
  5. Corneal edema: swelling of the cornea due to various factors, such as trauma, infection, or certain eye diseases.

It is important for patients who have had a corneal transplant to monitor their eye health closely and seek medical attention if they experience any symptoms of rejection, such as pain, redness, or blurred vision. Additionally, they should discuss any upcoming vaccinations with their healthcare provider to determine if any precautions, such as increased steroid use, may be necessary to prevent rejection.

Timeline

  • Before corneal transplant: The patient undergoes a laser eye surgery (FLEK) and receives a cornea transplant due to eye issues.
  • Two weeks after receiving the AstraZeneca COVID-19 vaccine, the patient experiences pain, redness, and blurred vision in her left eye.
  • Doctors diagnose the patient with acute corneal graft rejection, indicating that the body’s immune system is attacking the new cornea.
  • The patient is prescribed steroids and other medication to treat the rejection.
  • After five weeks of treatment, the patient’s vision improves significantly.
  • The case suggests a potential link between the COVID-19 vaccine and corneal transplant rejection, highlighting the importance of increasing steroid use before vaccination.

What to Ask Your Doctor

  1. What are the potential risks and complications of a corneal transplant?
  2. How likely is it for my body to reject the new cornea, and what are the signs I should watch out for?
  3. How will the COVID-19 vaccine affect my corneal transplant, and should I take any precautions before getting vaccinated?
  4. What medications will I need to take after the transplant to prevent rejection, and what are the side effects of these medications?
  5. How long is the recovery process after a corneal transplant, and what kind of follow-up care will I need?
  6. Are there any lifestyle changes or activities I should avoid to protect my new cornea?
  7. What is the success rate of corneal transplants, and what are the chances of needing a second transplant in the future?
  8. Are there any alternative treatments or therapies that I should consider before opting for a corneal transplant?
  9. How experienced are you in performing corneal transplants, and what is your success rate with this procedure?
  10. What should I do if I experience any complications or symptoms of rejection after the transplant?

Reference

Authors: Nahata H, Nagaraja H, Shetty R. Journal: Indian J Ophthalmol. 2022 May;70(5):1817-1818. doi: 10.4103/ijo.IJO_66_22. PMID: 35502082