Dear Editor,
We thank the authors for their interest and comments on the “Letter to the Editor”[1] section regarding our case report titled “Stromal rejection in penetrating keratoplasty following COVID-19 vector vaccine (Covishield) - A case report and review of literature” published in the January edition of the Indian Journal of Ophthalmology.
The concerns raised by the authors have been clarified below with the appropriate references:
There were no local inciting factors like loose sutures or vascularization, and the patient was systemically stable as discussed already in the case report. Like in most reports in literature, we have speculated that this could be vaccine induced. Rejection as late as 6 and 8 weeks following influenza booster and primary vaccination[2,3] has been reported in literature;
The patient did not report any systemic or ocular symptoms following the first dose of vaccination;
The patient was on a maintenance dose of topical steroids once a day and did not consult us prior to vaccination. Subsequent to the rejection episode, considering his single-eyed status, the patient was given hourly topical steroids and a short course of oral steroids that was gradually tapered as already mentioned in the case report;
The patient had systemic Hodgkin’s lymphoma and was given chemotherapy for 6 months in 2016 and none thereafter. The patient was reviewed periodically by his treating oncologist and was noted to be systemically stable at review 4 months prior to the presentation.
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Conflicts of interest
There are no conflicts of interest.
References
- 1.Gurnani B, Kaur K. Comment on: Stromal rejection in penetrating keratoplasty following COVID-19 vector vaccine (Covishield) – A case report and review of literature. Indian J Ophthalmol. 2022;70:2206. doi: 10.4103/ijo.IJO_264_22. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Solomon A, Frucht-Pery J. Bilateral simultaneous corneal graft rejection after influenza vaccination. Am J Ophthalmol. 1996;121:708–9. doi: 10.1016/s0002-9394(14)70638-5. [DOI] [PubMed] [Google Scholar]
- 3.Steinemann TL, Koffler BH, Jennings CD. Corneal allograft rejection following immunization. Am J Ophthalmol. 1988;106:575–8. doi: 10.1016/0002-9394(88)90588-0. [DOI] [PubMed] [Google Scholar]