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Abstract
Abstract
Graft Ulcers after Penetrating Keratoplasty due to Herpetic Inflammation - Detection by Polymerase-Chain-Reaction (PCR)
Sengler U.1, Reinhard T.2, Adams O.3, Schilgen G.1, Sundmacher R.1
1Eye Hospital and Institute for Med. Microbiology und 3Virology, Heinrich-Heine University, Duesseldorf
2Eye Hospital, Albert-Ludwigs-University, Freiburg
Purpose: An ulcer on a corneal graft is a serious complication after keratoplasty. Various reasons must be taken into account: Dry eye syndrom, suture loosening, immune reaction, bacterial infection, recurrences of rheumatic or herpetic eye disease. Though the latter shows some clinical particularities, the clinical findings are not so characteristic as in herpetic eye disease without a corneal graft. If a herpetic inflammation as underlying disease for the keratoplasty is not known or even suspected, serious complications may result.
Method: We describe 11 patients presenting with graft ulcers after penetrating keratoplasty. With some patients herpetic eye disease was suspected as they had had herpetic inflammations before, with others the possibility of herpetic infection had never been thought of. Some of these patients experienced corneal ulceration and even lytic infiltration of the graft repeatedly. Material from the ulceration harvested by a corneal swab was examined by PCR for Herpes simplex virus (HSV).
Results: With all patients the PCR was positive for HSV type 1. The ulceration was located at the margin of the corneal gr