Bilateral Cystoid Macular Edema and Corneal Endothelial Graft Rejection following Influenza and Varicella-Zoster Vaccinations.

Purpose: Multiple cases of corneal graft rejection after various vaccinations have been reported over the past decades. Here we described a case of bilateral cystoid macular edema (CME) and endothelial rejection in a DSAEK patient following influenza and varicella vaccines.

Case Report: A 72-year-old woman with bilateral Fuch's endothelial dystrophy received bilateral DSAEK surgeries. She received an influenza vaccination and her left visual acuity (VA) decreased due to CME. Half a year later, the patient received a varicella-zoster virus vaccine. 11 days later, she was found to have signs of endothelial graft rejection in both eyes. Unfortunately, her vision further deteriorated despite intensive topical steroid treatment.

Conclusions: In view of the current worldwide efforts on mass vaccination against the COVID-19 pandemic, we suggest an increased use of topical corticosteroids both before and after vaccination may be helpful in reducing this risk.