Abstract
AimWe 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.MethodsA...
Highlights
The cornea is an immune-p rivileged site, the most frequent cause of graft failure is allogeneic rejection.[1]
We describe two cases of Descemet’s membrane endothelial keratoplasty (DMEK) allograft rejection following COVID-19 immunisation and propose the possibility of a causal association
The effector response in endothelial rejection is characterised by anterior chamber (AC) infiltration of monocyte-derived macrophages, CD4+ and CD8+ T cells.[6]
Summary
The cornea is an immune-p rivileged site, the most frequent cause of graft failure is allogeneic rejection.[1]. Irrespective of whether the transplanted donor cornea is full or partial thickness, each rejection episode, even if reversed by treatment, causes irreversible loss of donor endothelial cells, which maintain corneal transparency. Progressive loss of endothelial cells results in decompensation and persistent stromal oedema with reduction in visual acuity. The COVID-19 pandemic has seen the rapid introduction of immunisation directed against SARS-C oV-2 in an effort to limit the spread of the disease and reduce its associated morbidity and mortality.[5] With the systematic state-sponsored vaccination efforts adopted by countries worldwide, very large numbers of patients with corneal transplants have had, or are set to have, SARS-C oV-2 vaccines. We describe two cases of DMEK allograft rejection following COVID-19 immunisation and propose the possibility of a causal association
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