Document Detail


Ping-pong transmission of herpes simplex virus 1 following corneal transplantation.
MedLine Citation:
PMID:  22532041     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Primary corneal graft failure (PCGF) after penetrating keratoplasty (PKP) despite good endothelial cell count of the transplant in organ culture rarely occurs in young patients. A herpes simplex virus type I (HSV-1) infection (transmission through the donor or reactivation by the patient) can lead to PCGF. METHODS: We report on a 43-year-old man with pellucid marginal corneal degeneration and neurodermitis, who was underwent penetrating keratoplasty (PKP) on the left eye after acute corneal hydrops in both eyes. A repeat keratoplasty (re-PKP) had to be performed 15 days after the first PKP due to a primary graft failure. A re-re-PKP with simultaneous amniotic membrane transplantation (as a patch) and partial lateral tarsorrhaphy became necessary 4 months after the re-PKP due to melting on the edge of the graft with persistent epithelial defects. RESULTS: After intensive cooperation between ophthalmologists and pathologists the histopathological findings showed keratocytes which reacted immunohistochemically positive for HSV-1 antigens in the deep corneal stroma of both corneal grafts. The excised own cornea of the patient was histopathologically negative but the DNA-PCR for HSV-1 was weakly positive. After adequate topical and systemic antiviral therapy the third graft has remained clear for 12 months. CONCLUSION: In cases of PCGF after normal risk corneal transplantation the possibility of HSV infection should always be considered. After confirmation of the diagnosis with the help of the immunohistochemical tests and/or PCR, an adequate treatment with antiviral medication (acyclovir tablets 2 × 400 mg for more than 1 year) should be administered to the patient after repeat PKP.
Authors:
E Stavridis; Z Gatzioufas; A Hasenfus; M Sauter; S Smola; B Seitz
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-25
Journal Detail:
Title:  Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft     Volume:  -     ISSN:  1433-0423     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206148     Medline TA:  Ophthalmologe     Country:  -    
Other Details:
Languages:  GER     Pagination:  -     Citation Subset:  -    
Affiliation:
Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Kirrberger Str. 1, 66424, Homburg/Saar, Deutschland, evangelos.stavridis@uks.eu.
Vernacular Title:
Ping-Pong-Transmission von Herpes-simplex-Virus 1 nach Hornhauttransplantation.
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