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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