Oral acyclovir after penetrating keratoplasty for herpes simplex keratitis.
OBJECTIVE
To determine the efficacy of systemic acyclovir in decreasing complications and improving the outcome of penetrating keratoplasty for herpes simplex virus (HSV) keratitis.


METHODS
Retrospective study of 53 primary penetrating keratoplasties for HSV keratitis at an eye hospital from January 1, 1989, through December 31, 1996. Medical records were analyzed for history of HSV keratitis, preoperative neovascularization, and disease activity. Postoperative use of acyclovir, recurrence of HSV keratitis, rejection, uveitis or edema, and graft failure were evaluated.


RESULTS
Twenty-four patients (mean +/- SD follow-up, 44.7 +/- 32.6 months) received no acyclovir and were compared with 20 patients, (mean +/- SD follow-up, 28.8 +/- 16.7 months), who received 400 mg acyclovir twice a day for at least 1 year. No patient in the acyclovir group had a recurrence of dendritic keratitis in the first year compared with 5 (21%) of the patients who did not receive acyclovir (P = .03). No patient had graft failure in the acyclovir group compared with 4 (17%) in the group without acyclovir after 1 year of follow-up (P = .06).


CONCLUSIONS
Postoperative systemic acyclovir therapy after penetrating keratoplasty for HSV keratitis is associated with a reduced rate of recurrent HSV dendritic keratitis and possible graft failure at 1 year of follow-up.
Tambasco
F P
FP
Cornea Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, PA, USA.
Cohen
E J
EJ
Nguyen
L H
LH
Rapuano
C J
CJ
Laibson
P R
PR
D000212:Acyclovir / Q000627:therapeutic use*; D000284:Administration, Oral; D000998:Antiviral Agents / Q000627:therapeutic use*; D015715:Corneal Edema / Q000517:prevention & control; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D018259:Herpesvirus 1, Human; D006801:Humans; D007635:Keratitis, Dendritic / Q000188:drug therapy / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012008:Recurrence; D012189:Retrospective Studies; D014606:Uveitis, Anterior / Q000517:prevention & control; D014792:Visual Acuity
D000998:Antiviral Agents; D000212:Acyclovir