scholarly journals Dual Corneal-Graft Rejection after mRNA Vaccine (BNT162b2) for COVID-19 during the First Six Months of Follow-Up: Case Report, State of the Art and Ethical Concerns

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1274
Author(s):  
Matteo Nioi ◽  
Ernesto d’Aloja ◽  
Maurizio Fossarello ◽  
Pietro Emanuele Napoli
Keyword(s):  
Graft Rejection ◽  
State Of The Art ◽  
Topical Therapy ◽  
Mass Vaccination ◽  
Corneal Graft ◽  
Ethical Concerns ◽  
Corneal Inflammation ◽  
Corneal Graft Rejection ◽  
Potential Vaccine

Present mass vaccination against Coronavirus Disease-19 (COVID-19) is the most widely used health policy and the most promising approach to curb the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic globally. However, new side effects are emerging from the mass vaccination not described during the experimental stages. In the present study, we discuss a case of acute corneal graft rejection, which has occurred 25 years after transplantation and 13 days after the administration of the BNT162b2 vaccine (Comirnaty, BioNTech/Pfizer), which was followed-up for a period of six months. In this period, the corneal inflammation appeared twice but was successfully managed with topical therapy and supplementation of Vitamin D. A risk of corneal graft rejection must be included in the list of potential vaccine complications, in order to inform the transplanted patient to undergo a preliminary and a follow-up ocular examination, and eventually to include corneal graft in the list of contraindications to vaccination.

scholarly journals Prediction of corneal graft rejection using central endothelium/Descemet’s membrane complex thickness in high-risk corneal transplants

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Taher Eleiwa ◽  
Amr Elsawy ◽  
Eyup Ozcan ◽  
Collin Chase ◽  
William Feuer ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Diagnosis ◽  
Graft Rejection ◽  
Repeated Measures ◽  
Corneal Thickness ◽  
Corneal Graft ◽  
Corneal Transplant ◽  
Corneal Graft Rejection ◽  
Corneal Transplants

AbstractTo determine whether measurements of Endothelium/Descemet complex thickness (En/DMT) are of predictive value for corneal graft rejection after high-risk corneal transplantation, we conducted this prospective, single-center, observational case series including sixty eyes (60 patients) at high risk for corneal graft rejection (GR) because of previous immunologic graft failure or having at least two quadrants of stromal vascularization. Patients underwent corneal transplant. At 1st, 3rd, 6th, 9th, and 12th postoperative month, HD-OCT imaging of the cornea was performed, and the corneal status was determined clinically at each visit by a masked cornea specialist. Custom-built segmentation tomography algorithm was used to measure the central En/DMT. Relationships between baseline factors and En/DMT were explored. Time dependent covariate Cox survival regression was used to assess the effect of post-operative En/DMT changes during follow up. A longitudinal repeated measures model was used to assess the relationship between En/DMT and graft status. Outcome measures included graft rejection, central Endothelium/Descemet’s complex thickness, and central corneal thickness (CCT). In patients with GR (35%), the central En/DMT increased significantly 5.3 months (95% CI: 2, 11) prior to the clinical diagnosis of GR, while it remained stable in patients without GR. During the 1-year follow up, the rejected grafts have higher mean pre-rejection En/DMTs (p = 0.01), compared to CCTs (p = 0.7). For En/DMT ≥ 18 µm cut-off (at any pre-rejection visit), the Cox proportional hazard ratio was 6.89 (95% CI: 2.03, 23.4; p = 0.002), and it increased to 9.91 (95% CI: 3.32, 29.6; p < 0.001) with a ≥ 19 µm cut-off. In high-risk corneal transplants, the increase in En/DMT allowed predicting rejection prior to the clinical diagnosis.

scholarly journals Histomorphological view of the cornea investigated by laser confocal microscopy in keratoplasty

2022 ◽  
pp. 110-117
Author(s):  
D. A. Krakhmaleva ◽  
Z. V. Surnina ◽  
S. A. Malzhoen ◽  
A. A. Gamidov
Keyword(s):  
Confocal Microscopy ◽  
Immune Cells ◽  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Corneal Graft ◽  
Rejection Reaction ◽  
Corneal Graft Rejection

Introduction. Corneal transplantation is the most successful and commonly performed allotransplantation procedure as compared with other organs and tissues. Over 100,000 corneal transplantations are performed worldwide every year.Purpose. This study investigated whether in vivo confocal microscopy (IVCM) can aid in the diagnosis of a graft rejection reaction by detecting changes in cellular structures and density of immune cells after penetrating keratoplasty.Materials and methods. The study included thirty-four eyes of 34 patients who underwent penetrating keratoplasty (7 eyes with corneal graft rejection, 27 without rejection). The average age of patients is 51.1 ± 13.6 years (from 23 to 76 years). The follow-up period ranged from 12 to 36 months (24.5 ± 4.84 months). Follow-up was performed at 1, 3, 6, 12 months and annually after PKP. To study the morphology of the cornea all patients underwent IVCM to assess the basal epithelium, subbasal layer, stroma and endothelium. Immune cells were identified and evaluated for the shape, length of the processes and their density.Results. Patients with corneal graft rejection demonstrated significant accumulation of corneal dendritic-like immune cells compared to patients with non-rejected grafts. In addition, the cells acquired a more mature morphology (grade 2–3). The density of dendritic cells (DC) was 809.17 ± 342.19 (p < 0.001). A positive correlation was found between DC density and graft rejection (p < 0.001). As well the patients showed signs of endothelial failure with low endothelial cell density and pleomorphism, increased light scattering and hyperreflectivity of the stroma.Conclusions. In a complex of diagnostic measures, confocal microscopy may provide a valuable clinical adjunctive tool in diagnosis and management of early corneal graft rejection.

Corneal Graft Rejection after Yellow Fever Vaccine: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Roberto Vignapiano ◽  
Lidia Vicchio ◽  
Eleonora Favuzza ◽  
Michela Cennamo ◽  
Rita Mencucci
Keyword(s):  
Case Report ◽  
Yellow Fever ◽  
Graft Rejection ◽  
Corneal Graft ◽  
Yellow Fever Vaccine ◽  
Corneal Graft Rejection

CORNEAL GRAFT REJECTION PROBABLY MEDIATED BY ANTIBODIES

2009 ◽  
Vol 59 (1) ◽  
pp. 119-125 ◽  
Author(s):  
NIELS EHLERS ◽  
THOMAS OLSEN ◽  
HANS ERIK JOHNSEN
Keyword(s):  
Graft Rejection ◽  
Corneal Graft ◽  
Corneal Graft Rejection

Efficacy and safety of microspheres of cyclosporin A, a new systemic formulation, to prevent corneal graft rejection in rats

2002 ◽  
Vol 24 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Ana I. Vallelado ◽  
M. Isabel López ◽  
Margarita Calonge ◽  
Alejandro Sánchez ◽  
M. José Alonso
Keyword(s):  
Cyclosporin A ◽  
Graft Rejection ◽  
Corneal Graft ◽  
Efficacy And Safety ◽  
Corneal Graft Rejection

Clinical Course of Different Types of Immune Reactions following Keratoplasty

2021 ◽  
Author(s):  
Philip Keye ◽  
Thabo Lapp ◽  
Daniel Böhringer ◽  
Sonja Heinzelmann ◽  
Philip Maier ◽  
...  
Keyword(s):  
Clinical Course ◽  
Corneal Graft ◽  
Long Term Outcomes ◽  
Immune Mediated ◽  
Corneal Graft Rejection ◽  
Different Types ◽  
Lost To Follow Up

Abstract Background Immune-mediated corneal graft rejection (IR) is a leading cause of corneal graft failure. The endothelium, stroma, epithelium, or a combination can be affected. Little is known about the long-term outcomes of different types of IR. Methods We reviewed the medical records of all keratoplasties that had been performed at our eye centre between 2003 and 2016 (n = 3934) for any kind of IR that occurred between the surgery and 2019. All patients with a definite diagnosis of IR and sufficient clinical data were included in the analysis. IRs were grouped according to the affected part of the graft (endothelial, stromal, epithelial, and mixed). We analysed the dynamics of recovery and the clinical outcomes. Results We identified a total of 319 patients with IR. Twenty-seven of those were lost to follow-up and were excluded from further analysis. Of the IRs, 89% affected the endothelium. Endothelial IR resulted more frequently in a considerable loss of endothelial cell density than other forms of IR. Stromal IR showed a lower relapse rate and a better visual recovery than other types of IR and resulted less often in a failure of the graft. Conclusions We herein report comprehensive data about the prognosis regarding functional recovery after different types of IR following keratoplasty. Our data underline that timely recognition and correct classification of IR are important because they determine the clinical course and prognosis.

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