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REJECTION OF A CORNEAL TRANSPLATATION IN A PATIENT AFTER COVID-
19 VACCINATION (clinical case)
Kamilov
H.M.
1
Rizaeva
M.A.
2
Hamraeva G.H.
1
Maksudova L.M.
1
1
Doctor of Medical Sciences, Associate Professor, Head of Department of
Ophthalmology, Center for Professional Development of Healthcare Workers under the
Ministry of Health of the Republic of Uzbekistan. Email:
Phone:+998901897683
2
Republican Clinical Ophthalmological Hospital - ophthalmologist Email:
1
Doctor of Medical Sciences, Associate Professor of Department of Ophthalmology,
Center for Professional Development of Healthcare Workers under the Ministry of
Health of the Republic of Uzbekistan. Email:
998903199723
1
Doctor of Medical Sciences, Associate Professor of Department of Ophthalmology,
Center for Professional Development of Healthcare Workers under the Ministry of
Health of the Republic of Uzbekistan. Email:
+998935950055
https://doi.org/10.5281/zenodo.12800157
Relevance.
Four years have passed since WHO declared the coronavirus a pandemic.
During this time, the disease claimed the lives of 6.8 million people. The SARS CoV 2 virus is
highly variable and is expected to disappear over time, becoming an endemic infection similar
to other respiratory infections. Corneal transplantation is a surgical treatment aimed at
restoring the optical and structural properties of a pathologically altered cornea. Exogenous
and endogenous causes can lead to transplant rejection, a sharp decrease in vision and
subsequent impairment of the patient's ability to work.
Purpose:
analysis of a clinical case of a patient with a corneal transplant.
Methods and techniques:
We observed a man aged 63 years. The patient underwent
general ophthalmological examination methods: visual acuity studies, external examination of
the eye, examination of the extraocular muscles, biomicroscopy, ultrasound examination of
the eyeballs.
Results.
From the medical history, the patient received a penetrating injury to the
corneoscleral region of the left eyeball in 2005 as a result of trauma. The patient underwent
primary surgical treatment of the eye after 6 months the injury, visual acuity of the left eye
was 0.04 uncorrectable. Biomicroscopy revealed a white clouding on the cornea. The patient
underwent penetrating keratoplasty of the left eye in 2008. According to the patient, the
postoperative period was without complications. Visual acuity improved to 0.5.
During the pandemic, the patient was vaccinated against coronavirus (SARS-CoV-2) ZF-
UZ-VAC 2021. Three weeks later, the patient was given a second dose of the vaccine. On the
third day, the patient began to experience pain, photophobia, and blurred vision in the left
eye. The patient was hospitalized in the inpatient department. Biomicroscopy revealed signs
of transplant rejection with edema of the corneal stroma and endothelium. The patient was
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prescribed local and systemic corticosteroid therapy. 1 month after treatment, complete
resolution of corneal stromal edema was observed, and no signs of rejection were observed.
At the same time, the corneal endothelium remained dim, visual acuity was equal to 0.3.
Conclusions.
Thus, in this clinical case acute rejection of donor corneal endothelium
occurred shortly after the administration of the COVID-19 vaccine. Timely initiation of
aggressive local and systemic corticosteroid therapy can lead to resolution of clinical signs
and symptoms of transplant rejection and improve visual function.
References
Vaccines allow people to develop immunity without exposing themselves to
the dangers of infection. Vaccinations often have mild to moderate side effects. This is because
the immune system triggers certain types of reactions in the div: stimulating increased
blood flow to allow more immune cells to circulate, and increasing div temperature to
destroy the virus
.
It is necessary to remember that any transplant surgery can have a
complication in the form of rejection of transplanted foreign tissue. International
organizations, including WHO, are carefully monitoring any side effects associated with the
use of the COVID-19 vaccine.
