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Systemic acyclovir and penetrating keratoplasty for herpes simplex keratitis
1Immunology Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
Documenta Ophthalmologica. Advances in Ophthalmology
|January 1, 1992
Summary
Oral acyclovir significantly reduces herpes simplex keratitis recurrence and corneal graft failure after transplantation. This antiviral prophylaxis improves outcomes for patients with a history of recurrent herpetic eye disease.
Area of Science:
- Ophthalmology
- Virology
- Immunology
Background:
- Herpes simplex keratitis (HSK) is a leading cause of corneal blindness worldwide.
- Recurrent HSK can lead to corneal scarring and graft failure after transplantation.
- Prophylactic antiviral therapy is crucial in managing HSK patients undergoing corneal procedures.
Purpose of the Study:
- To evaluate the efficacy of oral acyclovir in preventing HSK recurrence post-corneal transplantation.
- To assess the impact of acyclovir prophylaxis on corneal graft survival rates.
- To compare outcomes in HSK patients with and without postoperative oral acyclovir.
Main Methods:
- A retrospective study comparing two groups of patients undergoing corneal transplantation for HSK.
- One group received postoperative oral acyclovir, while the control group did not.
- Graft survival and HSK recurrence rates were monitored during follow-up.
Main Results:
- No HSK recurrences were observed in the acyclovir group (0/13) versus 44% in the non-acyclovir group (4/9).
- Corneal graft failure was significantly lower in the acyclovir group (14%, 2/14) compared to the non-acyclovir group (56%, 5/9).
- The differences in recurrence and graft failure rates were statistically significant (p < 0.01).
Conclusions:
- Long-term prophylactic oral acyclovir significantly decreases HSK recurrence.
- Acyclovir therapy substantially reduces corneal graft failure in HSK patients.
- Postoperative oral acyclovir is a vital strategy for improving outcomes in corneal transplantation for HSK.