The Possibility of Corneal Rejection

Your corneal transplant will most likely be successful, however there is a possibility your body will recognize the new corneal tissue as foreign and try to reject it. This can occur at any time, even years after the surgery.

With Penetrating Keratoplasty (full thickness Corneal Transplant), lifetime rejection occurs in about 20% of cases.
With Endothelial Keratoplasty (DSAEK and DMEK) and Deep Anterior Lamellar Keratoplasty (DALK), rejection rates are significantly lower, which is why these procedures, when they can be done, are usually preferable.

A cornea rejection can result in a cloudy cornea which may require a repeat transplant. This is most likely to happen if the rejection is not treated early in the course. If the rejection is caught early in its course however, it has a 90% chance of being reversed with medication. Therefore, it is extremely important to recognize the signs of impending rejection and report them as early as possible.

Rejection Warning Signs

Patients must call the office if any of these symptoms persist for 24 hours:

Decreased Vision: Decreased vision is the most common detected symptom of early corneal transplant rejection.

Increased Redness: After surgery there may be some redness or swelling, which should start improving slowly within a few days. If the eye instead gets redder or more swollen, please call.

Increased Pain: After surgery there may be some discomfort around the eye, but this should go away in a few days. If the eye becomes more uncomfortable, it could be a sign of rejection.

Increased Light Sensitivity: After surgery your eye(s) may be light sensitive. You will be given dark glasses to wear. The light sensitivity should slowly diminish over a few days or sometimes weeks. If it should worsen or recur once it has resolved, please call.

Precautions

1. Keeping the eye dropper or tube clean is essential. Avoid touching the top of the dropper or tube to anything, especially the fingers or any part of the eye.

2. Medication should be stored at room temperature; refrigerate only if you have been instructed to do so.

3. Use the medication only in the eye for which it is ordered.

4. Do not share your medication with anyone.

5. Use only the medication your physician has prescribed.

6. Never use eyedrops that have changed color.

7. Do NOT transfer medication from one bottle to another.

8. Keep eye medication out of reach of children.

9. Wait five minutes between consecutive drops.

10. When using both eyedrops and eye ointment, administer drops first.

At times, a flu vaccination may increase the risk of rejection. Patients who plan on getting a flu shot any time after surgery should notify their doctor. Drops may sometimes be prescribed before you receive the flu shot.

The information contained within these pages is intended for informational purposes only and does not take the place of consulting a physician.
Created by and for New York Cornea in association with Columbia University Medical Center.
Caring for your corneas since 1988.