eye disorders
Corneal Transplantation
Complications
Complications include the following: Graft rejection Infection (intraocular and corneal) Wound leak Overview of Glaucoma None Graft failure High refractive error (especially Overview of Refractive Error , Recurrence of disease (with Herpes Simplex Keratitis or hereditary corneal stromal dystrophy) Because no foreign endothelium is transplanted in DSO, there is no risk of rejection. Graft rejection rates for penetrating keratoplasty are usually<10% (eg, in patients with early bullous keratopathy), but they may be up to 68% in higher-risk patients (eg, those with chemical injury). Rejection rates are lower for DSEK than penetrating keratoplasty and even lower for DMEK at 1 to 3%. Rejection symptoms include decreased vision, photosensitivity, ocular ache, and ocular redness. Graft rejection is treated with topical corticosteroids (eg,prednisolone1% hourly), sometimes with a supplemental periocular injection (eg,triamcinoloneacetonide 40 mg). If graft rejection is severe or if graft function is marginal, additional corticosteroids are given orally (eg,prednisone1 mg/kg once/day) and occasionally IV (eg,methylprednisolone3 to 5 mg/kg once). Typically, the rejection episode reverses, and graft function returns fully. The graft may fail if the rejection episode is unusually severe or long-standing or if multiple episodes of graft rejection occur. Regraft is possible, but the long-term prognosis is worse than for the original graft. Keratoprosthesis (artificial cornea) can be placed if grafts fail repeatedly. 