Characteristics of endothelial corneal transplant rejection following immunisation with SARS-CoV-2 messenger RNA vaccine.
Br J Ophthalmol
; 105(7): 893-896, 2021 07.
Article
in English
| MEDLINE | ID: covidwho-1207486
ABSTRACT
AIM:
We report two cases of endothelial corneal allograft rejection following immunisation with SARS-CoV-2 messenger RNA (mRNA) vaccine BNT162b2 and describe the implications for management of transplant recipients postvaccination for COVID-19.METHODS:
A 66-year-old woman with Fuchs endothelial corneal dystrophy (FECD) and a unilateral Descemet's membrane endothelial keratoplasty (DMEK) transplant received COVID-19 mRNA vaccine BNT162b2 14 days post-transplant. Seven days later, she presented with symptoms and signs of endothelial graft rejection. An 83-year-old woman with bilateral DMEK transplants for FECD 3 and 6 years earlier developed simultaneous acute endothelial rejection in both eyes, 3 weeks post second dose of COVID-19 mRNA vaccine BNT162b2. Rejection in both cases was treated successfully with topical corticosteroids.CONCLUSIONS:
We believe this is the first report of temporal association between corneal transplant rejection following immunisation against COVID-19 and the first report of DMEK rejection following any immunisation. We hypothesise that the allogeneic response may have been initiated by the host antibody response following vaccination. Clinicians and patients should be aware of the potential of corneal graft rejection associated with vaccine administration and may wish to consider vaccination in advance of planned non-urgent keratoplasties. Patients should be counselled on the symptoms and signs that require urgent review to allow early treatment of any confirmed rejection episode.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Endothelium, Corneal
/
Immunization
/
Descemet Stripping Endothelial Keratoplasty
/
COVID-19 Vaccines
/
COVID-19
/
Graft Rejection
Type of study:
Case report
/
Observational study
Topics:
Vaccines
Limits:
Aged
/
Female
/
Humans
Language:
English
Journal:
Br J Ophthalmol
Year:
2021
Document Type:
Article
Affiliation country:
Bjophthalmol-2021-319338
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