Corneal transplant rejection

Abstract

The purpose of this article is to review the clinical findings of different types of corneal graft rejection and examine the different options of therapy, including well-established and new treatment modalities. A PubMed literature review search was performed, targeting recent articles on the subject of corneal graft rejection and therapies over the past 40 years. The conclusions of the review were that there are many types of corneal graft rejection, including epithelial, stromal, endothelial, or any combination thereof; 30% of patients will experience rejection episodes within the first year. Different therapies exist for the treatment of corneal transplant rejection. Corticosteroids can be administered by many routes and are the established standard for the treatment of corneal graft rejection. Cytotoxic agents, such as azathioprine can also be used for treatment, however, side effects and toxicity may limit its use. Cyclosporine is an increasingly used therapy for the treatment and prevention of corneal graft rejection, especially in patients at high risk of rejection, and can be produced to be taken orally or made into different strength topical formulations. Tacrolimus and rapamycin are the newest pharmaceuticals used to treat corneal graft rejection.