This past year has presented a host of challenges, particularly for those with existing health concerns. A portion of individuals with severe keratoconus undergo one or more corneal transplants when options like specialized contact lenses can no longer help achieve the best possible vision.
In the age of coronavirus, two common questions arise: Are individuals with corneal transplants at greater risk for contracting COVID-19? And, is it safe for someone with a corneal transplant to get the COVID-19 vaccine?
Dr. Christopher Sales, MD, MPH, Associate Professor of Ophthalmology at the University of Iowa reports that, “The average corneal transplant recipient is not at increased risk for contracting COVID-19 because of their use of steroid eye drops.” Eye surgeons will normally prescribe maintenance eyedrops for several months or even years after corneal transplant surgery to decrease the unlikely rejection of donor tissue. The drops concentrate their effect within the eye and do not have the same result that a medication designed to offer systemic (or body-wide) suppression would provide a patient who has had a transplant where the organ shares a blood supply like a heart, kidney, or liver. Dr. Sales observed, “Only local immune suppression is required for corneal transplants because the cornea is relatively sequestered from the body’s immune system. The tissue, a clear cornea does not contain any blood vessels. It is why your surgeon can transplant corneas without much, if any, concern for negative side effects on the rest of the body.”
An individual who has undergone corneal transplant should take the same precautions as anyone to avoid the virus – practice social distancing, frequent hand washing, masking when appropriate, and avoid touching your face and especially rubbing your eyes.
A second concern is that the COVID-19 vaccine may trigger an immune response and cause rejection of donor cornea tissue. You and your doctor may have had a similar discussion about taking seasonal flu vaccines, and it is best to follow your doctor’s advice. Evidence that cornea graft rejection has occurred due to vaccines is limited to a handful of case reports over the last forty years. The COVID-19 vaccine does not contain a live virus, and there have been no reported cases yet of rejection of corneal tissue from the COVID-19 vaccine.
Your doctor may recommend temporarily increasing the dosage of your steroid eyedrops to offer additional protection and offset any potential reaction. Contact your doctor if you have questions or concerns. To learn more about vaccines, visit the special COVID-19 CDC website.
Dr. Christopher Sales, MD, MPH is Associate Professor of Ophthalmology at the University of Iowa Carver School of Medicine in Iowa City, IA. A graduate of Tufts School of Medicine, he completed his ophthalmology residency at Stanford Univ. Medical Center and cornea fellowships in Portland, OR and at Lackland Air Force Base in San Antonio before joining the faculty at Cornell/Weill School of Medicine in NYC. Dr. Sales is active in state and national eye banking issues and is an expert in refractive surgery, advanced corneal transplant techniques and management of complicated ocular diseases like keratoconus.