Post-operative Management

Corneal transplantation has been successfully performed for over 100 years. Despite HLA typing and systemic immunosuppression not being routinely undertaken, 5-year survival rates exceed 90 % in corneal grafts with no current or past history of inflammation. However, graft survival decreases dramatically in the presence of risk factors that place it at high rejection risk, and immunological graft rejection remains the leading cause for graft failure. Post-operative management of corneal grafts requires stratification according to the risk for rejection and addressing this with appropriate prophylaxis. It is critically important to recognise corneal graft rejection early and initiate appropriate treatment, as a delay in diagnosis and treatment will result in failure to reverse rejection, or at least shorter graft survival if rejection is reversed.