Graft rejection episodes after keratoplasty in Japanese eyes

Wajima, Haguku; Hayashi, Takahiko; Kobayashi, Akira; Nishino, Tsubasa; Mori, Natsuko; Yokogawa, Hideaki; Yamagami, Satoru; Sugiyama, Kazuhisa

doi:10.1038/s41598-023-29659-w

Cited by 3 publications

(3 citation statements)

References 42 publications

(47 reference statements)

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“…Corneal graft rejection was defined as new endothelial precipitates with or without corneal edema, anterior chamber inflammation, rejection line, corneal vascularization, and peripheral anterior synechia. 12,13 Primary graft failure was defined as the failure of corneal clearance within 3 months of surgery.…”

Section: Methodsmentioning

confidence: 99%

Incidence of Graft Rejection in Descemet Membrane Endothelial Keratoplasty After COVID-19 mRNA Vaccination

Igarashi

Shimizu

Takeda

et al. 2023

Cornea

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Purpose: The aim of this study was to investigate the Descemet membrane endothelial keratoplasty (DMEK) rejection rate after COVID-19 vaccination with an mRNA vaccine. Methods: This was a multicenter, retrospective cohort study. A total of 198 patients who underwent DMEK between January 2006 and December 2020 were divided into 2 cohorts: consecutive patients who received at least 1 COVID-19 vaccination in 2021 (vaccination started from February 2021 in Japan) and nonvaccinated patients (control cohort). Patients who had a postoperative observation period of less than 90 days were excluded. The main outcome measurement was the incidence of graft rejection. A Cox proportional hazards regression model was used for comparisons with the nonvaccinated group. Results: Six rejection episodes were observed in 198 patients (124 nonvaccinated and 74 vaccinated patients), with 1 occurring in the nonvaccinated group and 5 in the vaccinated group. In the univariate model, vaccination had a significant effect on rejection episodes (P = 0.003). The effect of vaccination was also significant (P = 0.004) after adjusting for covariates. Conclusions: This study suggests that there may be a higher rejection rate after COVID-19 vaccination in patients who underwent DMEK. Patients should be warned of the rejection risk and its typical symptoms before receiving an mRNA COVID-19 vaccine, although further larger studies are needed to confirm the involvement of vaccination.

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Section: Methodsmentioning

confidence: 99%

Incidence of Graft Rejection in Descemet Membrane Endothelial Keratoplasty After COVID-19 mRNA Vaccination

Igarashi

Shimizu

Takeda

et al. 2023

Cornea

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“…Corneal transplantation, or keratoplasty, represents a critical surgical intervention for restoring vision in individuals affected by corneal opacities, dystrophies, or scarring [9][10][11]. Despite the procedure's notable success rates, the postoperative period is fraught with the challenge of immune-mediated graft rejection, a significant cause of graft failure and subsequent vision loss [11]. The introduction of the COVID-19 vaccine has sparked a debate over its potential impact on the incidence or intensity of corneal transplant rejection [12].…”

Section: Introductionmentioning

confidence: 99%

Risk of Corneal Transplant Rejection Following COVID-19 Vaccination: A Systematic Review and Meta-analysis

Gupta,

Padhi,

Abu Serhan

et al. 2024

Ophthalmol Ther

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Introduction The COVID-19 pandemic has initiated an unparalleled global vaccination campaign, raising concerns about the vaccine's effects on various health conditions, including the risk of corneal transplant rejection. This systematic review aimed to identify the relationship between COVID-19 vaccination and rejection of corneal transplant, filling a significant gap in the existing medical literature. Methods A literature search was performed across multiple databases up to February 12, 2024, to identify studies evaluating the risk of corneal transplant rejection post-COVID-19 vaccination. Eligible studies were original research that reported outcomes of corneal graft rejection following vaccination. Nested Knowledge web software facilitated screening and data extraction. The Newcastle–Ottawa Scale was employed for quality assessment. A meta-analysis was conducted to calculate the aggregated relative risk (RR) utilizing R software version 4.3. Results Six studies were included in the qualitative synthesis, with four meeting the criteria for meta-analysis. These studies varied in geographic location, surgical techniques, and types of vaccines used. The pooled RR for corneal transplant rejection following COVID-19 vaccination was 0.816 (95% CI 0.178–1.453), indicating no significant risk of rejection. No statistical heterogeneity was observed among the studies ( I 2 = 0%). Conclusions This review and meta-analysis found no significant evidence that COVID-19 vaccination increases the risk of corneal graft rejection. However, the current evidence is insufficient to conclusively determine the vaccine's safety for corneal transplant recipients. These findings underscore the need for additional research to confirm these preliminary results and investigate the long-term effects of COVID-19 vaccination on corneal transplants, aiming to provide evidence-based guidance to healthcare providers and patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-024-00941-y.

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“…However, few studies have reported a modi ed version of the DSEK procedure known as non-Descemet stripping endothelial keratoplasty (nDSEK), where the procedure of stripping off the Descemet membrane is no longer required. Thus prior studies have demonstrated positive clinical outcomes for both nDSEK [1,2] and non-Descemet stripping endothelial keratoplasty in DSAEK [3].…”

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confidence: 99%

Comparative study of efficacy and safety between nDSEK and DSEK for bullous keratopathy

Huang,

Yin,

Hoang

et al. 2024

Preprint

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Background Endothelial keratoplasty has evolved significantly through the utilization of different techniques. However, few studies have compared the clinical outcome between nDSEK (a modified version of the DSEK procedure known as non-Descemet stripping endothelial keratoplasty) and DSEK. This study aims to compare the potential efficacy and safety of nDSEK and DSEK in treating bullous keratopathy. Methods A retrospective comparative study included patients with bullous keratopathy underwent either nDSEK or DSEK between August 2017 and July 2022. These subjects were monitored for a period ranging from 6 to 36 months. The important factors such as best corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss (ECL), and any complications that occurred during the follow-up period were recorded. Results A total of 52 eyes from 52 patients with bullous keratopathy were included. All subjects underwent either nDSEK (24 eyes) or DSEK (28 eyes). The mean BCVA (logMAR) showed significant improvement from the preoperative measurement of 1.69 ± 0.23 to 0.47 ± 0.22 in nDSEK eyes and from the preoperative 1.67 ± 0.19 to 0.36 ± 0.17 in DSEK eyes respectively at postoperative 12 months. However, there was no statistically significant difference in improvement of BCVA between the nDSEK and DSEK eyes (P = 0.263). The mean donor ECD decreased from the preoperative 2848 ± 108 cells/mm2 to 1176 ± 269 cells/mm2 (ECL 59%) in nDSEK eyes and from the preoperative 2905 ± 132 cells/mm2 to 1235 ± 368 cells/mm2 (ECL 57%) in DSEK eyes respectively at postoperative 12 months, with no significant difference between the nDSEK and DSEK eyes (P = 0.185). The occurrence of various complications such as graft dislocation (8.3% in nDSEK eyes vs 3.6% in DSEK eyes, P = 0.891), acute high introcular pressure (4.2% in nDSEK eyes vs 7.1% in DSEK eyes, P = 1), primary graft failure (8.3% in nDSEK eyes vs 7.1% in DSEK eyes, P = 1), graft rejection (8.3% in nDSEK eyes vs 3.6% in DSEK eyes, P = 0.891) did not differ significantly between the nDSEK and DSEK eyes. Conclusions nDSEK eliminated the descemetorrhexis step but yielded a comparable clinical outcome in terms of both effectiveness and safety when compared to DSEK for treating bullous keratopathy.

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Graft rejection episodes after keratoplasty in Japanese eyes

Cited by 3 publications

References 42 publications

Incidence of Graft Rejection in Descemet Membrane Endothelial Keratoplasty After COVID-19 mRNA Vaccination

Incidence of Graft Rejection in Descemet Membrane Endothelial Keratoplasty After COVID-19 mRNA Vaccination

Risk of Corneal Transplant Rejection Following COVID-19 Vaccination: A Systematic Review and Meta-analysis

Comparative study of efficacy and safety between nDSEK and DSEK for bullous keratopathy

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