Five-year follow-up on the effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis.
OBJECTIVE
To investigate the long-term effect of oral acyclovir administered during the first 6 months after penetrating keratoplasty (PK) for herpetic eye disease (HED).


METHODS
A 5-year follow-up was undertaken for a patient population from a placebo-controlled, randomized trial on acyclovir prophylaxis after keratoplasty. In this former study the effectiveness of oral acyclovir prophylaxis was significant during the first 2 years after keratoplasty. Prospective data such as graft survival, graft clarity, vascularization, infective events, and rejection episodes were obtained from the national keratoplasty follow-up registry. Additional clinical data were derived from the medical charts.


RESULTS
For 47 of the original 63 enrolled patients, the 5-year follow-up was completed. Comparing the acyclovir group with the placebo group, we found that with regard to the cumulative clinically evident recurrences, there was a statistically significant lower monthly event rate in the acyclovir group (P = 0.037). There were no statistically significant differences in visual acuity or in the use of oral aciclovir between the two treatment groups. The incidences of graft failure, vascularization, and medication or surgery for glaucoma were too low to analyze differences between the two groups.


CONCLUSIONS
The results of our study suggest that oral acyclovir prescribed during the first 6 months after PK for HED protects against clinically evident HED recurrences during the first 5 years following PK.
Jansen
Aateke F G
AF
Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Rijneveld
Wilhelmina J
WJ
Remeijer
Lies
L
Völker-Dieben
Henny J M
HJ
Eggink
Catharina A
CA
Geerards
Annette J M
AJ
Mulder
Paul G H
PG
van Rooij
Jeroen
J
D000212:Acyclovir / Q000008:administration & dosage*; D000284:Administration, Oral; D000998:Antiviral Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016849:Keratitis, Herpetic / Q000188:drug therapy* / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D011182:Postoperative Care; D011183:Postoperative Complications; D011184:Postoperative Period; D055502:Secondary Prevention; D016896:Treatment Outcome; D014792:Visual Acuity
D000998:Antiviral Agents; D000212:Acyclovir