Graft rejection in component keratoplasty

Among the various indications for keratoplasty, failed graft is one of the commonest indications in many published series. It is well known that the major cause of graft failure is endothelial rejection. In the last two decades, there has been a major paradigm shift in the surgical management of corneal diseases, and component keratoplasty has emerged from the concept of replacing the layer that is actually diseased, rather than replacing the full-thickness cornea with the traditional penetrating keratoplasty. This has resulted in improved outcomes and the risk of endothelial rejection has reduced drastically, thus expanding the survival time of the graft. In recent years, reports of graft rejection in component keratoplasty have emerged, with each having a different presentation and responding to a different line of treatment. This review aims to summarize the presentation, diagnosis, and management of graft rejections in component keratoplasty.

[1]  M. Busin,et al.  COVID-19 Vaccination May Not Increase Rates of Corneal Graft Rejection , 2022, Cornea.

[2]  Takenori Inomata,et al.  Characteristics and Clinical Ocular Manifestations in Patients with Acute Corneal Graft Rejection after Receiving the COVID-19 Vaccine: A Systematic Review , 2022, Journal of clinical medicine.

[3]  W. Chamberlain,et al.  Acute Corneal Epithelial Rejection of LR-CLAL After SARS-CoV-2 Vaccination , 2021, Cornea.

[4]  C. Rapuano,et al.  Post Penetrating Keratoplasty Astigmatism. , 2021, Survey of ophthalmology.

[5]  Mauro Campos,et al.  Presumed DMEK Graft Rejection Associated With COVID-19 Infection. , 2021, Cornea.

[6]  K. Kenyon,et al.  Acute Corneal Transplant Rejection After COVID-19 Vaccination , 2021, Cornea.

[7]  A. Rowhani-Farid,et al.  Bilateral EK Rejection After COVID-19 Vaccine. , 2021, Eye & contact lens.

[8]  A. Saad,et al.  Acute corneal endothelial graft rejection following COVID-19 vaccination , 2021, Journal Français d'Ophtalmologie.

[9]  D. Gatinel,et al.  Descemet's membrane endothelial keratoplasty (DMEK) rejection following COVID-19 infection: A case report , 2021, American Journal of Ophthalmology Case Reports.

[10]  A. Wilder-Smith,et al.  COVID-19 vaccine impact in Israel and a way out of the pandemic , 2021, The Lancet.

[11]  D. Larkin,et al.  Characteristics of endothelial corneal transplant rejection following immunisation with SARS-CoV-2 messenger RNA vaccine , 2021, British Journal of Ophthalmology.

[12]  M. Farid,et al.  Posterior lamellar keratoplasty: techniques, outcomes, and recent advances , 2021, Journal of cataract and refractive surgery.

[13]  V. Sangwan,et al.  Allograft rejection after living-related simple limbal epithelial transplantation , 2021, Indian journal of ophthalmology.

[14]  M. Jager,et al.  New developments in corneal endothelial cell replacement , 2020, Acta ophthalmologica.

[15]  E. Holland,et al.  Long-term Outcomes of Living-Related Conjunctival Limbal Allograft Compared With Keratolimbal Allograft in Patients With Limbal Stem Cell Deficiency. , 2020, Cornea.

[16]  T. V. Kumary,et al.  Bioengineered corneal epithelial cell sheet from mesenchymal stem cells-A functional alternative to limbal stem cells for ocular surface reconstruction. , 2020, Journal of biomedical materials research. Part B, Applied biomaterials.

[17]  J. Yada.  [Graft rejection]. , 2020, Kangogaku zasshi.

[18]  G. Gao,et al.  A Novel Coronavirus from Patients with Pneumonia in China, 2019 , 2020, The New England journal of medicine.

[19]  K. Maruyama,et al.  Immune reactions after modern lamellar (DALK, DSAEK, DMEK) versus conventional penetrating corneal transplantation , 2019, Progress in Retinal and Eye Research.

[20]  C. Cursiefen,et al.  Midterm follow-up of immune reactions after Descemet membrane endothelial keratoplasty (DMEK) , 2019, Graefe's Archive for Clinical and Experimental Ophthalmology.

[21]  I. Dapena,et al.  Bowman layer transplantation in the treatment of keratoconus , 2018, Eye and Vision.

[22]  E. Campos,et al.  Immunologic Stromal Rejection After Deep Anterior Lamellar Keratoplasty With Grafts of a Larger Size (9 mm) for Various Stromal Diseases , 2018, Cornea.

[23]  S. Zaher,et al.  Twenty years of limbal epithelial therapy: an update on managing limbal stem cell deficiency , 2018, BMJ Open Ophthalmology.

[24]  T. Hayashi.  Mechanism of Immunologic Rejection After Deep Anterior Lamellar Keratoplasty. , 2018, Cornea.

[25]  David A. Price,et al.  Five-Year Graft Survival of Descemet Membrane Endothelial Keratoplasty (EK) versus Descemet Stripping EK and the Effect of Donor Sex Matching. , 2018, Ophthalmology.

[26]  N. Koizumi,et al.  Injection of Cultured Cells with a ROCK Inhibitor for Bullous Keratopathy , 2018, The New England journal of medicine.

[27]  I. Dapena,et al.  Quarter-Descemet membrane endothelial keratoplasty (Quarter-DMEK) for Fuchs endothelial corneal dystrophy: 6 months clinical outcome , 2018, British Journal of Ophthalmology.

[28]  Anthony N Kuo,et al.  Descemet Membrane Endothelial Keratoplasty: Safety and Outcomes: A Report by the American Academy of Ophthalmology. , 2017, Ophthalmology.

[29]  F. Price,et al.  Immunologic Rejection Episodes After Deep Anterior Lamellar Keratoplasty: Incidence and Risk Factors , 2017, Cornea.

[30]  A. Iovieno,et al.  Descemetorhexis Without Graft Placement for the Treatment of Fuchs Endothelial Dystrophy: Preliminary Results and Review of the Literature , 2017, Cornea.

[31]  Laurence E. Frank,et al.  Two-Year Clinical Outcome of 500 Consecutive Cases Undergoing Descemet Membrane Endothelial Keratoplasty , 2017, Cornea.

[32]  M. Hellmich,et al.  Incidence and Clinical Course of Immune Reactions after Descemet Membrane Endothelial Keratoplasty: Retrospective Analysis of 1000 Consecutive Eyes. , 2017, Ophthalmology.

[33]  N. Sharma,et al.  Descemet stripping automated endothelial keratoplasty , 2017, Indian journal of ophthalmology.

[34]  D. Böhringer,et al.  Descemet membrane endothelial keratoplasty for graft failure following penetrating keratoplasty , 2017, Graefe's Archive for Clinical and Experimental Ophthalmology.

[35]  G. Melles,et al.  360-Degree Scheimpflug Imaging to Predict Allograft Rejection After Descemet Membrane Endothelial Keratoplasty , 2016, Cornea.

[36]  E. Holland,et al.  Rate of Rejection After Descemet Stripping Automated Endothelial Keratoplasty in Fuchs Dystrophy: Three-Year Follow-up , 2016, Cornea.

[37]  D. O’Brart,et al.  Late Stromal Rejection in Deep Anterior Lamellar Keratoplasty: A Case Series , 2016, Cornea.

[38]  F. Kruse,et al.  Long-term Clinical Outcome After Descemet Membrane Endothelial Keratoplasty. , 2016, American journal of ophthalmology.

[39]  F. Price.  Descemet Membrane Endothelial Keratoplasty (DMEK) , 2016 .

[40]  D. Böhringer,et al.  Outcomes of Descemet membrane endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and penetrating keratoplasty from a single centre study , 2016, Graefe's Archive for Clinical and Experimental Ophthalmology.

[41]  Z. M. Mayko,et al.  The First 100 Eyes of Standardized Descemet Stripping Automated Endothelial Keratoplasty versus Standardized Descemet Membrane Endothelial Keratoplasty. , 2015, Ophthalmology.

[42]  D. Larkin,et al.  Transplant rejection following endothelial keratoplasty and penetrating keratoplasty in the United Kingdom: incidence and survival. , 2015, American journal of ophthalmology.

[43]  P. Rama,et al.  Modified big‐bubble technique compared to manual dissection deep anterior lamellar keratoplasty in the treatment of keratoconus , 2015, Acta ophthalmologica.

[44]  F. Price,et al.  Loteprednol Etabonate 0.5% Gel Vs. Prednisolone Acetate 1% Solution After Descemet Membrane Endothelial Keratoplasty: Prospective Randomized Trial , 2015, Cornea.

[45]  R. D. Stulting,et al.  Prevention and Treatment of Corneal Graft Rejection: Current Practice Patterns of the Cornea Society (2011) , 2015, Cornea.

[46]  I. Dapena,et al.  Hemi-Descemet membrane endothelial keratoplasty transplantation: a potential method for increasing the pool of endothelial graft tissue. , 2014, JAMA ophthalmology.

[47]  F. Kruse,et al.  Randomized Comparison of Topical Prednisolone Acetate 1% Versus Fluorometholone 0.1% in the First Year After Descemet Membrane Endothelial Keratoplasty , 2014, Cornea.

[48]  Silke Oellerich,et al.  Endothelial cell changes as an indicator for upcoming allograft rejection following descemet membrane endothelial keratoplasty. , 2014, American journal of ophthalmology.

[49]  C. Cursiefen,et al.  Evidence of Donor Corneal Endothelial Cell Migration From Immune Reactions Occurring After Descemet Membrane Endothelial Keratoplasty , 2014, Cornea.

[50]  L. Rosen,et al.  Immunologic graft rejection in descemet's stripping endothelial keratoplasty and penetrating keratoplasty for endothelial disease. , 2013, Ophthalmology.

[51]  Lixin Xie,et al.  Characteristics of immune rejection after allogeneic cultivated limbal epithelial transplantation. , 2013, Ophthalmology.

[52]  V. Sangwan,et al.  Successful management of immunological rejection following allogeneic simple limbal epithelial transplantation (SLET) for bilateral ocular burns , 2013, BMJ Case Reports.

[53]  N. Sharma,et al.  Stromal Rejection After Big Bubble Deep Anterior Lamellar Keratoplasty: Case Series and Review of Literature , 2013, Eye & contact lens.

[54]  E. Holland,et al.  Ocular Surface Stem Cell Transplantation Rejection: Incidence, Characteristics, and Outcomes , 2013, Cornea.

[55]  E. Tu,et al.  Stromal Rejection Following Deep Anterior Lamellar Keratoplasty: Implications for Postoperative Care , 2012, Cornea.

[56]  A. Djalilian,et al.  Postoperative Complications of Conjunctival Limbal Autograft Surgery , 2012, Cornea.

[57]  J. Mehta,et al.  Targeted corneal transplantation , 2012, Current opinion in ophthalmology.

[58]  S. Natarajan,et al.  Graft Rejection following descemet stripping automated endothelial keratoplasty: features, risk factors, and outcomes. , 2012, American journal of ophthalmology.

[59]  F. Roberts,et al.  Long term visual outcomes, graft survival and complications of deep anterior lamellar keratoplasty in patients with herpes simplex related corneal scarring , 2012, British Journal of Ophthalmology.

[60]  Marianne O Price,et al.  Risk of corneal transplant rejection significantly reduced with Descemet's membrane endothelial keratoplasty. , 2012, Ophthalmology.

[61]  S. MacNeil,et al.  Simple limbal epithelial transplantation (SLET): a novel surgical technique for the treatment of unilateral limbal stem cell deficiency , 2012, British Journal of Ophthalmology.

[62]  E. Balestrazzi,et al.  Graft Rejection After Femtosecond Laser–Assisted Deep Anterior Lamellar Keratoplasty: Report of 3 Cases , 2011, Cornea.

[63]  O. Arslan,et al.  Deep Anterior Lamellar Keratoplasty Using Big-Bubble Technique for Treatment of Corneal Stromal Scars , 2011, Cornea.

[64]  A. Kubaloğlu,et al.  Long-term results of deep anterior lamellar keratoplasty for the treatment of keratoconus. , 2011, American journal of ophthalmology.

[65]  V. Jhanji,et al.  Presumed Corneal Stromal Graft Rejection After Deep Anterior Lamellar Keratoplasty in a Patient with Systemic Lupus Erythematosis , 2010, Eye & contact lens.

[66]  K. Droutsas,et al.  Isolated Bowman layer transplantation to manage persistent subepithelial haze after excimer laser surface ablation. , 2010, Journal of cataract and refractive surgery.

[67]  S. Feizi,et al.  Deep Anterior Lamellar Keratoplasty in Patients with Keratoconus: Big-Bubble Technique , 2010, Cornea.

[68]  V. Sarnicola,et al.  Deep Anterior Lamellar Keratoplasty in Herpes Simplex Corneal Opacities , 2010, Cornea.

[69]  F. Price,et al.  Descemet's Membrane Endothelial Keratoplasty: Risk of Immunologic Rejection Episodes after Discontinuing Topical Corticosteroids. , 2009, Ophthalmology.

[70]  U. Stenevi,et al.  Survival of donor-derived cells in human corneal transplants. , 2009, Investigative ophthalmology & visual science.

[71]  R. Schulze.  Charles Tillett and the lost operation. , 2009, American journal of ophthalmology.

[72]  C. Jordan,et al.  Graft rejection episodes after Descemet stripping with endothelial keratoplasty: part one: clinical signs and symptoms , 2008, British Journal of Ophthalmology.

[73]  C. Jordan,et al.  Graft rejection episodes after Descemet stripping with endothelial keratoplasty: part two: the statistical analysis of probability and risk factors , 2008, British Journal of Ophthalmology.

[74]  Marianne O Price,et al.  Corneal Transplant Rejection Rate and Severity After Endothelial Keratoplasty , 2007, Cornea.

[75]  C. Tillett.  Posterior lamellar keratoplasty. , 2007 .

[76]  R. Tandon,et al.  One donor cornea for 3 recipients: a new concept for corneal transplantation surgery. , 2007, Archives of ophthalmology.

[77]  B. Zuberbuhler,et al.  Deep Anterior Lamellar Keratoplasty (DALK): Visual Outcome and Complications for a Heterogeneous Group of Corneal Pathologies , 2007, Cornea.

[78]  R. Tandon,et al.  Automated lamellar therapeutic keratoplasty (ALTK) in the treatment of anterior to mid-stromal corneal pathologies. , 2006, Acta ophthalmologica Scandinavica.

[79]  F. Price,et al.  Descemet's stripping with endothelial keratoplasty: comparative outcomes with microkeratome-dissected and manually dissected donor tissue. , 2006, Ophthalmology.

[80]  S. Tuft,et al.  Patterns of rejection after deep lamellar keratoplasty. , 2006, Ophthalmology.

[81]  A. Tait,et al.  Pathologies , 2006, Pathologies of Climate Governance.

[82]  S Louise Moffatt,et al.  Centennial review of corneal transplantation , 2005, Clinical & experimental ophthalmology.

[83]  F. Price,et al.  Descemet's stripping with endothelial keratoplasty in 50 eyes: a refractive neutral corneal transplant. , 2005, Journal of refractive surgery.

[84]  E. Mayhew,et al.  Cutting Edge: Atopy Promotes Th2 Responses to Alloantigens and Increases the Incidence and Tempo of Corneal Allograft Rejection1 , 2005, The Journal of Immunology.

[85]  S. Shimmura.  Component Surgery of the Cornea , 2004, Cornea.

[86]  R. H. Wijdh,et al.  A Technique to Excise the Descemet Membrane From a Recipient Cornea (Descemetorhexis) , 2004, Cornea.

[87]  T. Sherwin,et al.  Morphological changes in keratoconus: pathology or pathogenesis , 2004, Clinical & experimental ophthalmology.

[88]  S. Kaufman,et al.  Human fibrin tissue adhesive for sutureless lamellar keratoplasty and scleral patch adhesion: a pilot study. , 2003, Ophthalmology.

[89]  G. Melles,et al.  Transplantation of Descemet's Membrane Carrying Viable Endothelium Through a Small Scleral Incision , 2002, Cornea.

[90]  Mohammed Anwar,et al.  Big‐bubble technique to bare Descemet's membrane in anterior lamellar keratoplasty , 2002, Journal of cataract and refractive surgery.

[91]  M. Terry,et al.  Deep Lamellar Endothelial Keratoplasty in the First United States Patients: Early Clinical Results , 2001, Cornea.

[92]  Steven E. Wilson,et al.  Bowman's Layer Structure and Function: Critical or Dispensable to Corneal Function? A Hypothesis , 2000, Cornea.

[93]  Y. Tano,et al.  T-cell-mediated immune responses in alloepithelial rejection after murine keratoepithelioplasty. , 1999, Investigative ophthalmology & visual science.

[94]  Srinivas K. Rao,et al.  Limbal allografting from related live donors for corneal surface reconstruction. , 1999, Ophthalmology.

[95]  E. Pels,et al.  A surgical technique for posterior lamellar keratoplasty. , 1998, Cornea.

[96]  Michele De Luca,et al.  Long-term restoration of damaged corneal surfaces with autologous cultivated corneal epithelium , 1997, The Lancet.

[97]  J. Niederkorn,et al.  Anterior chamber-associated immune deviation promotes corneal allograft survival. , 1996, Investigative ophthalmology & visual science.

[98]  P. Binder,et al.  Epithelial-stromal interactions in human keratotomy wound healing. , 1995, Archives of ophthalmology.

[99]  S. Tseng,et al.  Human Allograft Limbal Transplantation for Corneal Surface Reconstruction , 1994, Cornea.

[100]  J. Streilein,et al.  Impaired cell-mediated immunity in mice bearing healthy orthotopic corneal allografts. , 1993, Journal of immunology.

[101]  E. J. Moticka,et al.  Ability of intracamerally inoculated B- and T-cell enriched allogeneic lymphocytes to enhance corneal allograft survival , 1993, International Ophthalmology.

[102]  B. Ksander,et al.  Evidence that active suppression contributes to the success of H-2-incompatible orthotopic corneal allografts in mice. , 1993, Transplantation proceedings.

[103]  E. J. Moticka,et al.  Intracameral injection of allogeneic lymphocytes enhances corneal graft survival. , 1990, Investigative ophthalmology & visual science.

[104]  S. Tseng,et al.  Limbal autograft transplantation for ocular surface disorders. , 1989, Ophthalmology.

[105]  G. Foulks,et al.  Expression of ABO Blood Group, Hematopoietic, and Other Cell‐Specific Antigens by Cells in the Human Cornea , 1985, Cornea.

[106]  J. Friend,et al.  Limbal epithelium in ocular surface wound healing. , 1982, Investigative ophthalmology & visual science.

[107]  S. Jacob.  Descemetorhexis , 2021, Evolution of Endothelial Keratoplasty and Relevant Terminologies.

[108]  I. Dapena,et al.  Repeat Descemet membrane endothelial keratoplasty after complicated primary Descemet membrane endothelial keratoplasty. , 2015, Ophthalmology.

[109]  M. Terry,et al.  Graft rejection after Descemet's stripping automated endothelial keratoplasty: graft survival and endothelial cell loss. , 2012, Ophthalmology.

[110]  P. Surynková,et al.  Surface Reconstruction , 2010 .

[111]  L. Fontana,et al.  Clinical outcomes after deep anterior lamellar keratoplasty using the big-bubble technique in patients with keratoconus. , 2007, American journal of ophthalmology.

[112]  M. Clement,et al.  PREVENTION AND TREATMENT , 1944 .