I am on the waiting list for an cornea transplant,?!

I am on the waiting list for an cornea transplant,?

I have been told that a second transplant, on the same eye (left) wont be as good as the first time it was done.

3 days ago
I suffer from fuchs' dystrophy.

The problems with penetrating keratoplasty, the second one, for Fuch's or any other type of corneal dystrophy is that your immune system is now 'aware' of the 'new' tissue as being foreign.

Normally, the cornea is avascular. There are no vessels for a number of reasons, one being that the tissue is just too 'tight' for vessels. But when you have a transplant, vessels do grow in from the sides, to the edge of the graft, and after noting that this tissue isn't 'yours', it takes part in a rejection reaction. The topical steroids and other topical as well as systemic medications are used to stop, delay, or control this reaction.

Now that your eye is aware that this is occurring, it realizes earlier that this is foreign tissue, you have a higher chance of rejecting the new cornea. The reason you are on a waiting list is probably that the 'lab' where you will be getting the cornea 'from' is 'typing' your tissue and the donor tissue to make as close a match as possible to avoid or to minimize the chance of a rejection.

Otherwise you'd get just 'any old' cornea that came along. And with Fuch's they're going to want a relatively 'young' cornea with as high an endothelial count as possible. That way you won't be getting corneal edema or decompensation from endothelial cell loss related to the inflammation from the surgery, and/or a possible later reaction to the graft itself.