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2001 Ocular Microbiology and Immunology Group, Abstract 3

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Recurrent Herpes Simplex Virus Keratitis after Penetrating Keratoplasty
P. Garg, H. Pandrowala, S. Athmanathan and A.K. Banasal
L.V. Prasad Eye Institute, Hyderabad, India

Purpose: To present the clinical profile of cases developing recurrent HSV keratitis after penetrating keratoplasty.

Methods: Retrospective observational case series.

Results: We identified 12 virology-proven cases of recurrent HSV keratitis between January 1999 and June 2001. The indications for keratoplasty were corneal scar (41.6%), active infiltrative keratitis (25%), corneal edema (8.5), failed graft (8.5%), and lattice dystrophy (8.5%). Four (33%) cases presented as dendritic ulcer, three (25%) as graft infiltrate, three (25%) as persistent epithelial defect, and two (16.7%) as geographic ulcer. The time interval between the keratoplasty and the recurrence ranged from one day to six years. The cases were managed with topical and systemic acyclovir therapy. Seven grafts failed, while five were clear at the last follow-up. In at least three cases donor tissue was suspected to be the source of infection.

Conclusions: Recurrent HSV keratitis is an important cause of graft morbidity even in developing countries. A high degree of clinical suspicion will help in the proper management of these cases. Latent virus in donor tissue may also be responsible for recurrent disease in the recipient.

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