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Impact of vaccination on keratoplasty.
Dugan, Sarah P; Mian, Shahzad I.
  • Dugan SP; Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
Curr Opin Ophthalmol ; 33(4): 296-305, 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-2257710
ABSTRACT
PURPOSE OF REVIEW Corneal graft rejection has been reported after coronavirus disease 2019 (COVID-19) vaccination. The purpose of this review is to evaluate the literature regarding corneal graft rejection after vaccination, including rejection rates and risk factors. We aim to create a framework to identify patients who are at higher risk for graft rejection and may warrant consideration of prophylactic interventions. RECENT

FINDINGS:

Graft rejection has been reported following administration of mRNA, viral vector, and inactivated whole-virion COVID-19 vaccines. Most cases had additional risk factors associated with rejection. Vaccination increases circulation of proinflammatory cytokines, CD4+ and CD8+ T-cell responses, and antispike neutralizing antibody, all of which may contribute to graft rejection. Two prospective studies have found no relationship between recent vaccination and rejection but 20% of cornea specialists report to have seen a vaccine-associated rejection and 22% recommend delaying vaccination in certain circumstances. Many specialists recommend prophylactic topical corticosteroids before and after vaccination to mitigate rejection risk but there is no evidence to support this practice on a wider scale.

SUMMARY:

Our framework identified 96.8% of penetrating keratoplasty patients with vaccine-associated rejection as higher risk. Further research is needed in order to develop evidence-based guidelines.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Corneal Transplantation / Corneal Diseases / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Curr Opin Ophthalmol Journal subject: Ophthalmology Year: 2022 Document Type: Article Affiliation country: ICU.0000000000000855

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Corneal Transplantation / Corneal Diseases / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Curr Opin Ophthalmol Journal subject: Ophthalmology Year: 2022 Document Type: Article Affiliation country: ICU.0000000000000855