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A serious adverse surgical event: Management of suspected HSV-1 keratitis in a donor cornea.
Spektrum Augenheilkd 2017; 31(1):19-22SA

Abstract

PURPOSE

To describe the management of a serious adverse event in a patient undergoing penetrating keratoplasty (PK).

CASE REPORT

A 68-year-old man underwent PK for an aphakic bullous keratopathy following previous complicated cataract surgery. He had no past history of herpetic disease. Storage of the corneoscleral disc in the transport bottle precluded microscopic examination. After placement of the trephined donor cornea on the open eye of the recipient, a large dendritiform geographic ulcer was noted on the donor cornea. A replacement cornea was used after changing potentially contaminated instruments. Intravenous antiviral treatment was commenced intraoperatively to reduce the risk of infection to the central nervous system. Postoperatively, oral and topical antiviral treatment was commenced and 6 months following surgery the patient developed a geographic corneal ulcer at the graft host interface.

CONCLUSION

Containers to transport corneoscleral discs should enable microscopic examination by the surgeon prior to use. High dose systemic antivirals may reduce the risk of herpetic disease involving the posterior segment of the eye and neuroretina in the aphakic eye and spread to the central nervous system.

Authors+Show Affiliations

Department of Eye and Vision Science, University Hospital Southampton, Tremona Road, SO16 6YD Southampton, UK.Department of Eye and Vision Science, University of Liverpool, Liverpool, UK.Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.Department of Eye and Vision Science, University of Liverpool, Liverpool, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28386160

Citation

Kaye, Rebecca, et al. "A Serious Adverse Surgical Event: Management of Suspected HSV-1 Keratitis in a Donor Cornea." Spektrum Der Augenheilkunde : Zeitschrift Der Osterreichischen Ophthalmologischen Gesellschaft, OOG, vol. 31, no. 1, 2017, pp. 19-22.
Kaye R, Steger B, Chen JY, et al. A serious adverse surgical event: Management of suspected HSV-1 keratitis in a donor cornea. Spektrum Augenheilkd. 2017;31(1):19-22.
Kaye, R., Steger, B., Chen, J. Y., & Romano, V. (2017). A serious adverse surgical event: Management of suspected HSV-1 keratitis in a donor cornea. Spektrum Der Augenheilkunde : Zeitschrift Der Osterreichischen Ophthalmologischen Gesellschaft, OOG, 31(1), pp. 19-22. doi:10.1007/s00717-016-0325-6.
Kaye R, et al. A Serious Adverse Surgical Event: Management of Suspected HSV-1 Keratitis in a Donor Cornea. Spektrum Augenheilkd. 2017;31(1):19-22. PubMed PMID: 28386160.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A serious adverse surgical event: Management of suspected HSV-1 keratitis in a donor cornea. AU - Kaye,Rebecca, AU - Steger,Bernhard, AU - Chen,Jern Y, AU - Romano,Vito, Y1 - 2017/01/30/ PY - 2016/09/17/received PY - 2016/12/16/accepted PY - 2017/4/8/entrez PY - 2017/4/8/pubmed PY - 2017/4/8/medline KW - Corneal Transplant KW - Donor KW - Herpes Simplex (HSV) KW - Keratitis KW - Recipient SP - 19 EP - 22 JF - Spektrum der Augenheilkunde : Zeitschrift der Osterreichischen Ophthalmologischen Gesellschaft, OOG JO - Spektrum Augenheilkd VL - 31 IS - 1 N2 - PURPOSE: To describe the management of a serious adverse event in a patient undergoing penetrating keratoplasty (PK). CASE REPORT: A 68-year-old man underwent PK for an aphakic bullous keratopathy following previous complicated cataract surgery. He had no past history of herpetic disease. Storage of the corneoscleral disc in the transport bottle precluded microscopic examination. After placement of the trephined donor cornea on the open eye of the recipient, a large dendritiform geographic ulcer was noted on the donor cornea. A replacement cornea was used after changing potentially contaminated instruments. Intravenous antiviral treatment was commenced intraoperatively to reduce the risk of infection to the central nervous system. Postoperatively, oral and topical antiviral treatment was commenced and 6 months following surgery the patient developed a geographic corneal ulcer at the graft host interface. CONCLUSION: Containers to transport corneoscleral discs should enable microscopic examination by the surgeon prior to use. High dose systemic antivirals may reduce the risk of herpetic disease involving the posterior segment of the eye and neuroretina in the aphakic eye and spread to the central nervous system. SN - 0930-4282 UR - https://www.unboundmedicine.com/medline/citation/28386160/A serious_adverse_surgical_event:_Management_of_suspected_HSV-1_keratitis_in_a donor_cornea L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28386160/ DB - PRIME DP - Unbound Medicine ER -