Tags

Type your tag names separated by a space and hit enter

Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis.
Graefes Arch Clin Exp Ophthalmol 2012; 250(8):1187-94GA

Abstract

PURPOSE

To evaluate the therapeutic effect of deep anterior lamellar keratoplasty (DALK) in patients with herpetic stromal keratitis (HSK).

METHODS

Forty-three eyes belonging to 42 patients with HSK, including 22 eyes in the active phase and 21 eyes in the quiescent phase, underwent DALK at the Shandong Eye Institute from January 2006 to December 2009. All patients with active disease had received intravenous acyclovir and amniotic membrane implants prior to DALK. Herpes simplex virus type 1 (HSV-1) antigens from excised corneal buttons were detected by immunohistochemistry.

RESULTS

The follow-up ranged from 1 to 4 years (mean, 29.1 months). Graft rejection occurred in one eye (2.3%) and was reversed. Among the other 42 survived grafts (97.7%), 37 remained clear at the last visit. The best spectacle-corrected visual acuity was 20/200 or better in 95.2% of eyes and 20/40 or better in 38.1% of eyes. Six eyes (14.0%) developed recurrent HSK, one of which received a second keratoplasty due to ineffective antiviral medication. There were no significant differences in endothelial cell density between 6 months and 12 months after the surgery. By immunohistochemistry, HSV-1 antigens were observed in the stroma of 18 of 32 corneal buttons.

CONCLUSIONS

DALK can not only remove the corneal lesions of HSK but also reduce latent or persistent viral loads in the cornea. In eyes with active or quiescent HSK but otherwise healthy endothelia, DALK seems to be safe and promising for its favorable visual outcome, graft survival rate, and low endothelial cell loss.

Authors+Show Affiliations

Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22349979

Citation

Wang, Junyi, et al. "Therapeutic Effect of Deep Anterior Lamellar Keratoplasty for Active or Quiescent Herpetic Stromal Keratitis." Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, vol. 250, no. 8, 2012, pp. 1187-94.
Wang J, Zhao G, Xie L, et al. Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis. Graefes Arch Clin Exp Ophthalmol. 2012;250(8):1187-94.
Wang, J., Zhao, G., Xie, L., Chen, M., & Zhao, J. (2012). Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, 250(8), pp. 1187-94. doi:10.1007/s00417-012-1947-2.
Wang J, et al. Therapeutic Effect of Deep Anterior Lamellar Keratoplasty for Active or Quiescent Herpetic Stromal Keratitis. Graefes Arch Clin Exp Ophthalmol. 2012;250(8):1187-94. PubMed PMID: 22349979.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis. AU - Wang,Junyi, AU - Zhao,Ge, AU - Xie,Lixin, AU - Chen,Min, AU - Zhao,Jing, Y1 - 2012/02/17/ PY - 2011/09/05/received PY - 2012/01/27/accepted PY - 2012/01/04/revised PY - 2012/2/22/entrez PY - 2012/2/22/pubmed PY - 2012/10/27/medline SP - 1187 EP - 94 JF - Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie JO - Graefes Arch. Clin. Exp. Ophthalmol. VL - 250 IS - 8 N2 - PURPOSE: To evaluate the therapeutic effect of deep anterior lamellar keratoplasty (DALK) in patients with herpetic stromal keratitis (HSK). METHODS: Forty-three eyes belonging to 42 patients with HSK, including 22 eyes in the active phase and 21 eyes in the quiescent phase, underwent DALK at the Shandong Eye Institute from January 2006 to December 2009. All patients with active disease had received intravenous acyclovir and amniotic membrane implants prior to DALK. Herpes simplex virus type 1 (HSV-1) antigens from excised corneal buttons were detected by immunohistochemistry. RESULTS: The follow-up ranged from 1 to 4 years (mean, 29.1 months). Graft rejection occurred in one eye (2.3%) and was reversed. Among the other 42 survived grafts (97.7%), 37 remained clear at the last visit. The best spectacle-corrected visual acuity was 20/200 or better in 95.2% of eyes and 20/40 or better in 38.1% of eyes. Six eyes (14.0%) developed recurrent HSK, one of which received a second keratoplasty due to ineffective antiviral medication. There were no significant differences in endothelial cell density between 6 months and 12 months after the surgery. By immunohistochemistry, HSV-1 antigens were observed in the stroma of 18 of 32 corneal buttons. CONCLUSIONS: DALK can not only remove the corneal lesions of HSK but also reduce latent or persistent viral loads in the cornea. In eyes with active or quiescent HSK but otherwise healthy endothelia, DALK seems to be safe and promising for its favorable visual outcome, graft survival rate, and low endothelial cell loss. SN - 1435-702X UR - https://www.unboundmedicine.com/medline/citation/22349979/Therapeutic_effect_of_deep_anterior_lamellar_keratoplasty_for_active_or_quiescent_herpetic_stromal_keratitis_ L2 - https://dx.doi.org/10.1007/s00417-012-1947-2 DB - PRIME DP - Unbound Medicine ER -