RESULTS AND COMPLICATIONS AFTER PENETRATING KERATOPLASTY FOR HERPETIC KERATITIS
R.-C. Lerche1, C. D. Quentin2, M. Vogel2
Purpose: Medication resistance recurring herpetic keratitis is often followed by irreversible corneal damage. Therefore often a penetrating keratoplasty is necessary. Typical postoperative complications are recurrence of herpetic keratitis, graft failure and suture-problems. In a retrospective study graft survival and complications after penetrating keratoplasty for herpetic keratitis were evaluated. The effectiveness of medication with Cyclosporine A and Aciclovir was analiezed.
Patients: 25 penetrating keratoplasties in 11 men (44%) and 14 women (56%), average age of 55,8 years, were performed because of corneal scaring with reduction of visual acuity after herpetic keratitis. The mean follow-up-time was 53,2 months.
Results: In 15 eyes (60%) postpperative improvement of visual acuity was registered. 3 eyes (12%) showed kn decrease of vision, in 7 eyes (28%) no change was recognized. Graft rejection or recurrence of herpetic keratitis were observed in 10 cases (40%), a re-keratoplasty followed in 3 patients. The first episode of graft- failure occured in mean after 17,5 years. Suture-loosening was seen in 20% (5 eyes). Cyclosporine A and Aciclovir were used in 12 patients, the graft-rejection rate was significant lower (30,4%).
Conclusion: Graft failure after penetrating keratoplasty for herpetic keratitis is a frequent severe complication. Prophylactic and therapeutical systemic application of Cyclosporine A and Aciclovir seems to improve the prognosis for keratoplasty. In this point further prospective studies are necessary.
1Universitäts-Augenklinik Hamburg, Martinistrasse 52, D-20246 Hamburg
2Universitäts-Augenklinik Göttingen, Robert-Koch-Str. 40, D-37073 Göttingen