Primary transplant failure is when the transplant immediately fails to function correctly directly after a cornea transplant. Transplant failure can occur many years after a cornea transplant. This is known as secondary transplant failure.
Risk factors for secondary transplant failure include continuous (and accelerated) postoperative endothelial decrease or rejection responses. These factors can be triggered by glaucoma, ocular surface disease, bonding-related issues and the ingrowth of blood vessels in the cornea. Additionally, social-economic and geographic aspects and the initial indication on which the decision for a cornea transplant was based affect the occurrence of transplant failure.
Advancing corneal oedema will further impair vision, and fluid blisters may form on the cornea and rip, resulting in painful micro-defects on the surface of the cornea.
To make a correct diagnosis, chart any changes to the disease and determine the right follow-up or treatment, several tests will be carried out during your visit to our outpatients’ clinic, like:
In some cases (in the early stages), the symptoms can be reduced using eye drops or cream. If this is impossible or does not work sufficiently, a retransplant can be carried out. The improperly functioning posterior layer of the donor cornea (the endothelium and the Descemet membrane) will be replaced by a donor membrane with a posterior lamellar cornea transplant (endothelial keratoplasty), like DMEK. You can find more information about the various surgical techniques under “Treatments”.
