what is after rejection?

[eman samir]

hello everyone....i am always wondering what is the next step if the tarnsplanted cornea is rejected?

[rosemary johnson]

Hi eman,
AIUI, if it starts to reject, you get to the hospital quickly.
Signs of rejection - it's red and sore and streaming; the world looks misty and you can't see so well; and the bright light is more bright and painful than ever.
If it is caught early, they can turn around most rejections - normally with monotonously regular doses of anti-rejection steroid eyedrops.
Or even immuno-suppresant drugs...
Bottom line is, it is possible these won't work - maybe one's immune system is particularly strong at repelling foreign invaders. Maybe the rejection episode wasn't caught quickly enough, or...... or it was "just one of those things"
And in that case, again as I understand it, the transplant just gets totally rejected - and will go white and you can't see through it.
At that point you have two alternatives:
1. just accept it's happened and live with one eye - with or without an eyepatch if walking round with a white eye makes you feel more conspicuous that the eye patch (!), a white stick or guide dog.
2. try another transplant. Which this time they will do lots of tissue typing for, and may use stronger antirejection drugs. possibly even the immuno-suppressants that people who've had heart, etc, transplants have. And hope it doesn't reject this time.
Most of them do get turned round (or so I@m told) - the whiteness clears and you can eventually start to reduce the drops again. And you get more regular checkups meanwhile.
Which of 1. and 2. is better for any individual depends on lots of things, of course..... the person's mentality, the state of the other eye, how rapidly an ddrastically the rejection happened, possibility of the drugs not working on them, etc etc etc.
Rosemary

[Andrew MacLean]

I think that there is some confusion over the word "Rejection". People in the forum tend to use it as shorthand for "rejection episode". This is when the transplanted tissue begins to show signs of being rejected by the body. The reason the advice is given to go directly to the ophthalmologist is there are any signs of rejection is that it is usually possible to turn around the rejection episode and enable the new cornea to settle into the host eye.

Signs of a rejection can be remembered by the simple Mnemonic RSVP

R Redness
S Sensitivity to light
V Vision loss
P Pain

As Rosemary says, if a rejection is allowed to follow its course there may be no alternative to a second transplant.

All the best

Andrew