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Primary graft failure caused by herpes simplex virus type 1.

R J De Kesel¹, C Koppen, M Ieven

¹Middelheim Hospital, Department of Ophthalmology, Antwerp, Belgium.

|March 15, 2001

Summary

Herpes simplex virus type 1 (HSV-1) may cause primary graft failure (PGF) after corneal transplantation. This study identified HSV-1 in four patients experiencing PGF, suggesting a causal link for this serious complication.

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Area of Science:

Ophthalmology
Virology
Immunology

Background:

Primary graft failure (PGF) following penetrating keratoplasty (PKP) can significantly impact visual outcomes.
The etiology of PGF is multifactorial, and infectious causes are being increasingly investigated.

Observation:

A cluster of four consecutive PGF cases after PKP within 17 days at a single institution was observed.
Herpes simplex virus type 1 (HSV-1) was investigated as a potential cause for these PGFs, unrelated to the initial indication for PKP.

Findings:

Viral cultures of conjunctival swabs and bandage contact lenses detected HSV-1 in three and one patient, respectively.
Polymerase chain reaction (PCR) confirmed HSV-1 in the aqueous humor and corneal graft tissue of three patients, and in iris tissue of all four.

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Immunohistopathology was positive for HSV-1 in three of the four PGF cases.

Implications:

These findings provide strong evidence supporting HSV-1 as a causative agent of PGF after PKP.
Early identification and potential antiviral treatment strategies for HSV-1-associated PGF warrant further investigation.
Understanding infectious etiologies like HSV-1 is crucial for improving corneal graft survival rates.