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Santhiya from Singapore asked a question

How can vision be restored after cornea graft rejection?

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Eye & LASIK

I'm a 23 years old female diagnosed with keratoconus. The left side was very advanced, so my doctor recommended a cornea transplant. However, the graft started to reject after approximately 2 months. I've been prescribed with prednisolone and pred forte eye drops for the last 2 weeks, but there has not been any improvement. I would like a second opinion as to whether there is any way for vision restoration, as my vision has been reduced to counting fingers in my left eye.

DOCTOR’S ANSWER (2)

Hi Santhiya

Corneal graft rejection is a condition that can occur if your body's immune system recognizes the graft as 'foreign' and then starts attacking it.

Nowadays, there are several kinds of corneal transplant operations that can be performed for keratoconus.

Usually, we try to perform 'deep anterior lamellar keratoplasty' (DALK) where the abnormal collagenous stroma is replaced but your own inner corneal lining (endothelium) is preserved. Sometimes, the entire thickness of cornea may need to be replaced in a procedure called 'penetrating keratoplasty' (PK).

If you had DALK, the rejection is often reversible as it does not affect the corneal endothelium. If you had PK and endothelial rejection, the cornea may still be cleared sometimes if the rejection was detected and treated early enough.

However, sometimes when the endothelium is damaged beyond a certain level, the cornea may remain hazy because the damaged endothelium cannot regenerate. Further surgery may even be necessary sometimes-it all depends.

As you can see, the possibility of restoring your vision and the options for achieving that depend on a number of things, some of which we will only know after a full assessment with other instruments during a full clinic consult.

I would suggest that if you would like a second opinion, that you arrange an appointment with a corneal specialist so that the necessary information can be obtained to advise you further.

0 188 views 1 Doctors agree Tue May 15 2018 05:56:16 GMT+0000 (UTC)

Hello Santhiya,

So sorry to hear about your poor vision after corneal graft surgery for keratoconus surgery. Unfortunately corneal grafts can fail or get rejected for many reasons after surgery. This often results in blurred vision which sounds like the case for you. 

Your cornea specialist would be able to maximise your outcome by treating you appropriately for the graft rejection. If in the long-term the graft is not optically viable, then unfortunately there are few other options for future visual rehabilitation apart form a repeat cornea graft.

Until that time though, you should pursue maximal medical therapy in an attempt to salvage any useful vision from the existing graft.

0 173 views 0 Doctors agree Wed May 16 2018 05:32:13 GMT+0000 (UTC)
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