title: Successful corneal autograft after clearance of anterior chamber cytomegalovirus with oral valganciclovir in a patient with multiple failed corneal allografts.
abstract: OBJECTIVE
  To report a case of recurrent corneal graft failure because of cytomegalovirus (CMV) infection and to demonstrate successful clearance of the virus with oral valganciclovir, confirmed by polymerase chain reaction (PCR) assay. This allowed for a successful corneal autograft to be performed.
  
  
  METHODS
  Interventional case report.
  
  
  RESULTS
  A 90-year-old white man with 4 previous corneal graft failures in his right eye is presented. His visual acuity was no light perception in the left eye subsequent to ocular trauma. His initial penetrating keratoplasty for pseudophakic bullous keratopathy was from a human leukocyte antigen-matched multiorgan donor who was CMV-seropositive. An anterior chamber paracentesis was performed to exclude an infective etiology. CMV was detected on PCR of aqueous humor. After a 12-week course of oral valganciclovir, a repeat aqueous PCR test confirmed the clearance of CMV. A corneal autograft from his left eye was subsequently performed with good outcome.
  
  
  CONCLUSIONS
  We present a case of successful corneal autograft after clearance of CMV from the anterior chamber (PCR confirmed) in a patient treated with oral valganciclovir.
authors.affiliation: Sydney Eye Hospital, Sydney, Australia. jed.lusthaus@gmail.com
authors.forename: Jed A
authors.initials: JA
authors.lastname: Lusthaus
authors.forename: Peter
authors.initials: P
authors.lastname: Kim
authors.forename: Alicia K
authors.initials: AK
authors.lastname: Steller
authors.forename: Zin
authors.initials: Z
authors.lastname: Naing
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Scott
authors.forename: William D
authors.initials: WD
authors.lastname: Rawlinson
authors.forename: Lyon P
authors.initials: LP
authors.lastname: Robinson
authors.forename: Peter J
authors.initials: PJ
authors.lastname: McCluskey
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Wechsler
mesh_terms: D000284:Administration, Oral; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000821:virology*; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000601:surgery* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000188:drug therapy / Q000601:surgery* / Q000821:virology; D015774:Ganciclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006084:Graft Rejection / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D016133:Polymerase Chain Reaction; D012008:Recurrence; D012086:Reoperation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000077562:Valganciclovir; D015774:Ganciclovir