Abstract
A previously reported cohort of patients4 was reviewed after mean follow-up of 10.9 years. The overall probability of survival was 45%, but first grafts had a greater probability of survival than second (P= 0.12) or further (P= 0.19) grafts. Preoperative active keratitis adversely affected survival (P= 0.123). The major cause of failure was graft rejection. Regrafts were more likely to fail from rejection episodes (P= 0.0005). Antiviral prophylaxis improved the outcome for rejection (P= 0.005) and reduced the incidence of HSK recurrence complicating rejection. Suppurative keratitis occurred in 12.4% of grafts as a complication of epitheliopathy including HSK recurrence. The outcome in these cases was particularly poor. Loose continuous graft sutures resulted in graft failure in 10.6% of grafts which may be improved by using interrupted suturing. Our results suggest the longterm prognosis for grafting in herpes simplex keratitis are not as good as may have been predicted from previous analyses.
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References
Ormsby HL : Keratoplasty for herpetic keratitis. Am J Ophthelmol 1958, 45: 179.
Fine M : Treatment of herpetic keratitis by corneal transplantation. Am J Ophthalmol 1958, 46: 671.
Rice NSC and Jones BR : Problems of comeal grafting in herpetic keratitis. CIBA Foundation Symposium 15: Corneal graft failure. Ed Jones BR. Amsterdam: Elsevier 1973, 221–39.
Cobo LM, Coster DJ, Rice NSC, Jones BR : plantation for herpetic keratitis. Arch Ophthalmol 1980; 98:1755–9.
Cohen EJ, Laibson PR, Arentsen JJ : Comeal transplantation for herpes simplex keratitis. Am J Ophthalmol 1983, 95:645–50.
Kaplan EL and Meier P : Non parametric estimation from incomplete observations. Am J Stat Assoc 1958, 53: 457–81.
Foster CS and Duncan J : Penetrating keratoplasty for herpes simplex keratitis. Am J Ophthalmol 1981; 92: 336–43.
Volker-Dieben HJ, Kok-van Alphen CC, D'Amaro J, de Lange P . The effect of prospective HLA-A and B matching in 288 penetrating keratoplasties for herpes simplex keratitis. Acta Ophthalmol 1984, 62: 513–23.
Fine M and Cignetti FE : Penetrating keratoplasty in herpes simplex keratitis. Arch Ophthalmol 1977, 95: 613–6.
Polack FM and Kaufman HE : Penetrating keratoplasty in herpetic keratitis. Am J Ophthalmol 1972, 73: 908–13.
Khoudadost AA and Silverstein SB : Studies on the nature of the privilege enjoyed by corneal allografts. Invest Ophthalmol 1972, 11: 137–48.
Epstein RJ, Seedor JA, Dreizen NG, Stulting RD, Waring GO, Wilson LA, Cavanagh HD : Penetrating keratoplasty for Herpes simplex keratitis and keratoconus. Ophthalmol 1987, 94: 935–44.
Krachmer JH and Alldredge DC : Subepithelial infiltrates - a probable sign of corneal transplant rejection. Arch Ophthalmol 1978, 96: 2234.
Langston RHS, Pavan-Langston D, Dohlman CH : Antiviral medication and corneal wound healing. Arch Ophthalmol 1974, 92: 509–13.
Patterson A and Jones BR : The management of ocular herpes. Trans Ophthalmol Soc UK 1967, 87: 537–79.
Young E, Stark WJ, Prendergast RA : Immunology of corneal allograft rejection, HLA-DR antigens on human corneal cells. Invest Ophthalmol Vis Sci 1985, 26: 571–4.
Puelhorn G, Sosath G, Thiel H-J : The effect of 5-iodo-2-deoxyuridine (IDU) and dexamethasone on corneal wound healing in the rabbit. Acta Ophthalmol 1978, 56: 40–52.
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Presented at the Annual Congress of the Ophthalmological Society of the United Kingdom, April, 1988.
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Ficker, L., Kirkness, C., Rice, N. et al. Longterm prognosis for corneal grafting in herpes simplex keratitis. Eye 2, 400–408 (1988). https://doi.org/10.1038/eye.1988.73
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DOI: https://doi.org/10.1038/eye.1988.73
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