Abstract
Abstract: :
Purpose: To compare the morbidity and visual outcomes of eyesundergoing penetrating (PK) or deep lamellar keratoplasty (DLK)for herpes simplex virus (HSV) keratitis.Method: We performed a retrospective case review of all thosepatients undergoing PK or DLK for HSV keratitis at Moorfields.Only those patients having their first ever graft between Sept1994 and Jan 2002 were included. Over each year of follow upwe counted the total number of outpatient visits and the numberof inflammatory episodes due to graft rejection, HSV recurrenceor a mixture of both. At the end of each year of follow up werecorded the visual acuity, IOP, best corrected acuity, andwhether the graft had failed. Grafts were deemed to have failedwhen they were so thin or opaque or had such high astigmatismthat a regraft was performed. No data was collected beyond thefailure date.Results: 25 patients were identified. 11 had a PK, 14 had aDLK. All were followed for at least 1 year, 19 were followedfor 2 years. Penetrating keratoplasty was performed for tectonicreasons in 8 cases, the corresponding figure for lamellar surgerywas 1. Morbidity and visual outcome results are summarised intables 1 and 2. None of the differences between graft typeswas significant. All graft failures were for rejection and/orscarring. Table 1–graft morbidity over the first 2 post–opyears.
Table 2–distribution of visual acuity after 1 and 2 years Conclusion: In this series of patients undergoing their firstkeratoplasty for HSV keratitis, DLK can give functional resultsbut offers no advantage in visual outcome or morbidity overPK over the first 2 years of follow up.
Keywords: cornea: clinical science • transplantation • herpes simplex virus