Reversal of Rejection in a Patient Undergoing Penetrating Keratoplasty for Keratoconus
Keywords:
keratoconus, keratoplasty, corneal transplantation, graft rejection, graft failureAbstract
Despite advances in surgical techniques and immunosuppression, the rate of corneal graft rejection is significant, its management is a challenge for the ophthalmologist, and the recovery of graft transparency is the fundamental goal of treatment. We present a male pediatric patient, diagnosed with advanced keratoconus, operated of penetrating keratoplasty in both eyes at the cornea service of the Cuban Institute of Ophthalmology Ramón Pando Ferrer, who developed rejection to the transplant 10 months after the keratoplasty in the first eye, which was reversed with medical therapy. More than 10 years after the first transplant, the patient has a transparent graft, 1.0 vision and tomographic stability in both eyes.
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1. Condo Reyes AG, Cervantes Anaya LA. Alternativas terapéuticas del Queratocono. Vive Rev. Salud. 2022 [acceso 05/02/2024];5(15):841-51. Disponible en: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S2664-32432022000300841&lng=es
2. Henriquez MA, Randleman Bradley J. Keratoconus: Definitions. En: Izquierdo LJr, Henriquez MA, Mannis MJ. Keratoconus Diagnosis and Management. Elsevier: USA; 2023. p. 11-22.
3. Saad S, Saad R, Goemaere I, Cuyaubere R, Borderie M, Borderie V, et al. Efficacy, Safety, and Outcomes following Accelerated and Iontophoresis Corneal Crosslinking in Progressive Keratoconus. Journal of Clinical Medicine. 2023;12:2931. DOI: 10.3390/jcm12082931
4. Jareño Ochoa M, Pérez Parra Z, Castillo Pérez AC, Padilla González C, León Rodríguez Y, de los Santos Arroniz KV. Modificaciones refractivas luego del tratamiento del queratocono con crosslinking corneal en ocho años de evolución. Rev Cubana Oftalmol. 2020 [acceso 05/11/2023];33(1):1-9. Disponible en: https://revoftalmologia.sld.cu/index.php/oftalmologia/aticle/view/933
5. Pérez Parra Z, Jareño Ochoa M, Fernández García K, Casas Arias X, Noriega Martínez JL, Fuentes González M. Seguridad de la queratoplastia lamelar anterior profunda versus queratoplastia penetrante en el tratamiento del queratocono. Rev Cubana Oftalmol. 2020 [acceso 05/02/2024];33(1):e828. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762020000100005&lng=es
6. Oviedo N, Moya E, Velastegui E. Queratoplastia lamelar vs Queratoplastia penetrante. MEDICIENCIAS UTA. 2020 [acceso 01/01/2024];4(3):4-13. Disponible en: https://scholar.googleusercontent.com/scholar?q=cache:awFPByLsFu0J:scholar.google.com/+dalk+en+queratcono&hl=es&as_sdt=0,5&as_ylo=2020
7. Ting D, Sau C, Srinivasan S, Ramaesh K, Mantry S, Roberts F. Changing trends in keratoplasty in the West of Scotland: a 10-year review. Br J Ophthalmol. 2012 [acceso 01/01/2024];96(3):405-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21733923/
8. McGhee C, Kim B, Wilson P. Contemporary treatment paradigms in keratoconus. Cornea. 2015 [acceso 05/02/2024];34(Suppl 10):S16-23. Disponible en: https://journals.lww.com/corneajrnl/fulltext/2015/10001/contemporary_treatment_paradigms_in_keratoconus.4.aspx
9. Mohammadpour M, Heidari Z, Hashemi H. Updates on managements for keratoconus. J Curr Ophthalmol. 2017 [acceso 05/01/2024];30(2):110-24. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034171/
10. Cassidy D, Beltz J, Jhanji V, Loughnan M. Recent advances in corneal transplantation for keratoconus. Clin Exp Optom. 2013 [acceso 02/02/2024];96:165–72. Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/cxo.12047
11. Oyeniran E, Tauqeer Z. Update in the management of keratoconus. Adv Ophthalmol Optometry. 2021 [acceso 05/02/2024];6(6):307–24. DOI: 10.1016/j.yaoo.2021.04.019
12. Pérez Parra Z, Padilla González C, Jareño Ochoa M, Gómez Castillo Z, Guerra Almaguer M, Sibila González M. Modificaciones corneales posqueratoplastia penetrante óptica. Rev Cubana Oftalmol. 2017 [acceso 05/02/2024];30(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762017000100003&lng=es
13. Velazquez Monzon K, Navarro Peña MC, Klunder Klunder M, Tsatsos M, Ramírez Ortíz MA. Pediatric penetrating keratoplasty and graft rejection: experience at the Hospital Infantil de México Federico Gómez. Bol Med Hosp Infant Mex. 2020;77(1):23-7. DOI: 10.24875/BMHIM.19000070
14. Al-Torbak A, Malak M, Teichmann KD, Wagoner MD. Presumed stromal graft rejection after deep anterior lamellar keratoplasty. Cornea 2005;24(2):241-3. DOI: 10.1097/01.ico.0000141230.95601.95
15. Watson SL, Tuft S, Dart JK. Rejection following deep lamellar keratoplasty
(DLK). Invest Ophthalmol Vis Sci. 2003 [acceso 05/02/2024];44(13):4683. Disponible en: https://iovs.arvojournals.org/article.aspx?articleid=2416482
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