Assessment of Corneal Graft Rejection Rates Following Partial Endothelial Keratoplasty in COVID-19 Vaccinated Patients

Abstract Objectives: The study aims to investigate the incidence of graft rejection following Covid-19 vaccination among patients who had undergone partial endothelial keratoplasty, a form of corneal transplantation. Methods: The study involved 208 patients who had received two doses of Covid-19 vaccine after undergoing partial endothelial keratoplasty. Patients were identified through electronic medical records and evaluated using a questionnaire designed to assess symptoms of graft rejection. Results: None of the 208 patients complained of symptoms of acute graft rejection, nor presented with symptoms or signs of graft rejection in the given time frame. None of the patients were diagnosed with graft rejection elsewhere. Conclusions: The study did not identify any cases of partial endothelial keratoplasty corneal graft rejection after the first or second dose of the Covid-19 vaccine. The absence of blood and lymphatic vessels in the central cornea gives it lymphangiogenic privilege and low rate of graft rejection. Any systemic immune dysregulation may compromise corneal ocular immune privilege and increase the patient’s susceptibility to rejection. Although all reported cases of corneal graft rejection following Covid-19 vaccination were associated with symptoms, the study has limitations as it relied solely on a telephonic survey.