Corneal transplant rejection after initiation of systemic antineoplastic agents

Abstract

In this case series, we describe corneal transplant rejection after initiation of various antineoplastic agents. In our first case, an 85-year-old woman with previous Descemet-stripping automated endothelial keratoplasty of the right eye presented with decreased vision in the same eye after initiation of platinum taxane compounds and doxorubicin; examination demonstrated decreased acuity and corneal edema. In our second case, a 60-year-old woman with previous penetrating keratoplasty (PKP) in the left eye presented with irritation in the same eye after starting ipilimumab; examination showed keratic precipitates. In our last case, a 68-year-old woman with PKPs in both eyes presented with bilaterally decreased acuity, corneal edema, and anterior chamber reaction after initiating tamoxifen. These patients were diagnosed with rejection within 4 weeks of beginning their respective antineoplastic therapies and they were treated with topical prednisolone with or without hypertonic ointment (Muro 128). Close observation might be warranted in patients with corneal grafts starting antineoplastic therapy.