In some patients, the corneal astigmatism can be reduced in the early postoperative period by suture adjustment or selective suture removal. In many patients, earlier and better vision is attained with a rigid contact lens over the corneal transplant. To protect the eye from inadvertent trauma after transplantation, the patient wears shields, glasses, or sunglasses. In addition, patients are advised to avoid bending over completely, lifting heavy objects, straining, or the Valsalva maneuver. Graft rejection is not uncommon.
Patients complain of decreased vision, photosensitivity, ocular ache, and ocular redness.
The graft may fail if the graft rejection was unusually severe or long-standing or after multiple episodes of graft rejection. Regraft is possible, but the long-term prognosis for a clear regraft is lower than it was for the original graft. The prognosis for a clear, functioning corneal transplant varies by diagnosis. The generally high rate of success of corneal transplantation is attributable to many factors, including the avascularity of the cornea and the fact that the anterior chamber has venous drainage but no lymphatic drainage. Another important factor is the effectiveness of the immunosuppressive drugs used to treat graft rejection.