NDLI: The outcome of deep anterior lamellar keratoplasty in herpes simplex virus-related corneal scarring, complications and graft survival.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Awan, M. A. Roberts, F. Hegarty, B. Ramaesh, K.
Description	Country affiliation: United kingdom Author Affiliation: Awan MA ( Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, UK. dramer_awan@yahoo.co.uk)
Abstract	AIMS: To determine the visual outcome, graft survival and complications after deep anterior lamellar keratoplasty (DALK) in patients with herpes simplex virus (HSV)-related corneal scarring. METHODS: A retrospective analysis of the patients who had DALK for HSV-related corneal scarring between January 2004 and February 2007 was performed. Mean follow-up was 30 months (range 16-48 months). The statistical significance of host corneal vascularisation was determined using Fisher's exact test. RESULTS: There were 18 eyes from 18 patients and the mean age was 57 years. Preoperative visual acuity ranged from hand movements (HM) to 6/12. Fifty per cent of the eyes achieved visual acuity of 6/12 or better postoperatively. Six eyes (33%) had recurrence of HSV-related inflammation, eight eyes (including four eyes with recurrence of HSV-related inflammation) developed graft rejection and four eyes (including two eyes with recurrence of HSV-related inflammation) had bacterial keratitis. The graft survival rate was 83%. Three eyes developed glaucoma and one eye required trabeculectomy. Immunohistochemistry revealed that HSV was focally positive or equivocal in four recipient corneal buttons, and transmission electron microscopy showed intracellular HSV virions in two of them. CONCLUSIONS: This is the largest series of DALK for herpetic corneal scarring that shows a comparable visual outcome and better graft survival rate than penetrating keratoplasty. There is significant risk of recurrence of HSV-related inflammation and graft rejection that requires timely recognition and adequate management.
File Format	HTM / HTML
ISSN	00071161
Issue Number	10
Volume Number	94
e-ISSN	14682079
Journal	British Journal of Ophthalmology
Language	English
Publisher	BMJ Publishing Group Ltd.
Publisher Date	2010-10-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Keratitis, Herpetic Corneal Transplantation Microscopy, Electron, Transmission Recurrence Cornea Adverse Effects Humans Middle Aged Graft Survival Male Treatment Outcome Cicatrix Visual Acuity Transplantation, Homologous Journal Article Virology Discipline Ophthalmology Pathology Ultrastructure Surgery Female Graft Rejection Retrospective Studies Methods
Content Type	Text
Resource Type	Article
Subject	Ophthalmology Sensory Systems Cellular and Molecular Neuroscience

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