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2020, Number 1

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Rev Cub Oftal 2020; 33 (1)

Penetrating keratoplasty with and without antiviral therapy in herpetic keratopathy

Mokey CMO, Álvarez RMB

Language: Spanish
References: 20
Page: 1-11
PDF size: 338.87 Kb.


ABSTRACT

Objective: Identify the optical or therapeutic outcome of penetrating keratoplasty in patients with herpetic keratopathy.
Methods: A descriptive cross-sectional study was conducted in which a presentation was made of the results of the scope of penetrating keratoplasties for herpetic keratopathy performed at Hermanos Ameijeiras Clinical Surgical Hospital in Havana.
Results: The sample was 33 penetrating keratoplasties: 24 optical (72.7%) and 9 tectonic (27.3%). Visual acuity was lower than or equal to 0.3 in 5 of them. Of the total sample, 9 opacified, 11 had postoperative complications, 8 recurred in optical penetrating keratoplasties, and 6 in therapeutic penetrating keratoplasties. Rejection occurred in 7 optical penetrating keratoplasties (33.3%) and 4 therapeutic penetrating keratoplasties (4%). Complications were observed in 5 (25%) optical penetrating keratoplasties and 6 (55.6%) therapeutic penetrating keratoplasties. In the postoperative period 22 (66.6%) had a visual acuity greater than or equal to 0.3 (p= 0.0000).
Conclusions: Inactivity of corneal viral disease benefits the prognosis of grafting due to herpetic keratopathy in opacities of optical keratoplasties. Pre- and postoperative antivirals were found to reduce the recurrence of herpetic disease on the graft and rejection, achieving better visual acuity and greater viability. Postoperative inflammatory severity is associated to an active viral disease or an immune disorder at the time of the grafting resulting in post keratoplasty complications.


REFERENCES

  1. Krachmer J, Mannis M, Holland E. Cornea e-book. Ámsterdam: Elsevier; 2010: 967-8.

  2. Liesegang T. Herpes simplex virus epidemiology and ocular importance. Cornea. 2001;20:1

  3. The herpetic eye disease study group: Predictors of recurrent herpes simplex virus keratitis. Cornea. 2001;20:123-8.

  4. Inoue Y. Review of clinical and basic approaches to corneal endotelitis. Cornea. 2014;33(Suppl. 11):53-8.

  5. Herpetic Disease Study Group. Psychological stress and other potential triggers for recurrences of herpes simplex virus eye infections. Arch Ophthalmol. 2000;118(12):1617- 25.

  6. Pérez-Santoja JJ, Hervás-Hernandis JM. Queratitis infecciosas. Fundamentos, Técnicas Diagnósticas y Tratamiento. Ergon; 2006.

  7. Moshirfar M. A review of corneal endotheliitis and endotheliopathy: differential diagnosis, evaluation and treatment. Ophthalmol Ther. 2018 [acceso: 22/01/2019]. Disponible en: https://doi.org/10.1007/s40123019-0169-7

  8. Mokey Castellanos MO. Indicaciones de la queratoplastia en un centro de referencia nacional. Rev Cubana Oftalmol. 2000;13(1):30-4.

  9. Santics U. Changing trends in corneal graft surgery: a ten year review. Int J Ophthalmol. 2016;9(1):48-52.

  10. Fuchsluger TA, Kruse FE. High-Risk Corneal Transplantation. Cour Ser Bas Karg. 2015;6:74-80.

  11. Gittins-Núñez LO. Risk factors and rejection frecuency in patients undergoing penetraiting keratoplasty. Rev Med Inst Seg Soc. 2016;54(2):2.

  12. Mokey Castellanos MO. Rechazo y Retrasplante Corneal. Rev Cubana Oftalmol. 2007 [acceso: 22/01/2019]. 20(2). Disponible en http://www:Revcuboftalmol@infomedsld.cu

  13. Mohammad-Reza J. Traumatic wound dehiscence following corneal transplantation. J Ophthalmolic Vis Res. 2012;7(3):214.

  14. Boyton Grace E, Wordward MA. Evolving Techniques in corneal transplantation. Curr Surg Rep. 2016;3(2):5.

  15. Hill JC. The mecanism and management of corneal graft rejection. Hill Kugler Publications; 1996.

  16. García L, Almaraz García M, Herreras JM. Análisis retrospectivo del efecto del tratamiento con aciclovir vía oral sobre el resultado final de las queratoplastias realizadas por queratitis herpética. Archivos de la Sociedad Española de Oftalmología; 1998.

  17. Tsatsos M, Mac Gregor C, Athanasiadis I, Moschos MM, Hossain P, Anderson D. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents. Clin Exp Ophthalmol. 2016;44(9):824-37.

  18. White ML, Chodosh J. Herpes simplex virus keratitis: a treatment guideline. American Academy of Ophthalmology; 2014.

  19. Tuli SS, Chodosh J. Herpes simplex virus: diagnosis and management. Ophthalmic News & Education Network: American Academy of Ophthalmology; 2014.

  20. Sudesh S, Laibson PR. The impact of the herpetic eye disease. In: Mannis J, Holland EJ. Cornea. Fundamental, Diagnosis and Management. Elsevier; 2017.




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