Corneal Graft Rejection Follow-up

Updated: Mar 19, 2014
  • Author: Michael Taravella, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Follow-up

Further Outpatient Care

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  • Patients should receive follow-up care for corneal graft rejection as needed.

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Complications

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  • Depending on the degree of injury sustained by the graft, graft rejection episodes can progress to graft failure due to rejection.

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Prognosis

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  • The sooner an episode of graft rejection is detected clinically and therapy is begun, the better the prognosis for graft survival. The rate of reversal of corneal endothelial graft rejection has been reported from 50-91%, depending on the clinical setting. In general, the prognosis is good if therapy is immediately instituted.

  • Depending on the degree of irreversible damage to the graft endothelium, even markedly edematous grafts may clear again. Once endothelial destruction has progressed to the point where the remaining endothelial function is inadequate to maintain deturgescence, the graft fails and becomes irreversibly edematous. Unfortunately, the endothelium has no or at best a very limited capacity for repair through mitosis.

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Patient Education

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  • No symptoms are related universally to graft rejection.

  • Astute patients may complain of a decrease in visual acuity, redness, pain, irritation, and photophobia. Patients may also be asymptomatic.

  • Any patient with a corneal graft should be instructed to seek ophthalmologic care urgently if these symptoms persist for more than a few hours.

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