Penetrating keratoplasty for varicella-zoster virus keratopathy.
OBJECTIVE
To examine and report the results of penetrating keratoplasty performed in patients with varicella-zoster virus keratopathy.


METHODS
The authors retrospectively reviewed the records of 15 patients who had penetrating keratoplasty for varicella-zoster virus keratopathy from January 1989 through December 1998 on the Cornea Service at Wills Eye Hospital.


RESULTS
Twelve patients had a preoperative diagnosis of herpes zoster ophthalmicus, and three, of varicella. Four eyes had lateral tarsorrhaphies performed in conjunction with penetrating keratoplasty. Three eyes had endothelial rejection episodes that responded well to treatment with topical steroids. One eye had a regraft 1 month after primary failure, and this second graft also failed because of recurrent neurotrophic keratopathy. Three eyes that had repeated penetrating keratoplasty for graft failure had clear grafts at the last examination. At an average follow-up time of 50 months, 13 (86.7%) grafts remained clear, and the best corrected visual acuity was 20/100 or better in eight (53.3%) eyes. Five patients had decreased visual acuity because of retinal diseases.


CONCLUSIONS
Although varicella-zoster virus keratopathy is an uncommon indication for penetrating keratoplasty, effective visual rehabilitation can be achieved in these patients. Careful postoperative management, frequent lubrication, and lateral tarsorrhaphies to protect the corneal surface are major factors in the successful outcome of these cases.
Tanure
M A
MA
Cornea Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
Cohen
E J
EJ
Grewal
S
S
Rapuano
C J
CJ
Laibson
P R
PR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000473:pathology / Q000601:surgery* / Q000821:virology; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006084:Graft Rejection / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D006563:Herpes Zoster Ophthalmicus / Q000473:pathology / Q000601:surgery* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions