title: [Postoperative therapy after penetrating keratoplasty in herpes simplex keratitis].
abstract: BACKGROUND
  Keratitis due to herpes simplex infection is a common cause of corneal damage resulting in impaired vision.
  
  
  OBJECTIVE
  The aim of this study was to assess the outcome of penetrating keratoplasties in patients treated with systemic antiviral and immunosuppressive drugs.
  
  
  METHODS
  The authors retrospectively analysed data of 12 patients who underwent penetrating keratoplasty. The average age at onset of the first keratitis preceding surgery was 18 years (between 5 and 40 years). The indication for surgery in 9 cases was to improve vision and in 3 patient to prevent corneal perforation. Nine patients were given both acyclovir and mycophenolate mofetil, as anti-viral agent and immunosuppressive treatment, respectively. Two patients were treated with anti-viral agent only while one patient received no systemic therapy. The average follow-up time was 53.1 months (between 16 and 84 months).
  
  
  RESULTS
  Of the 9 patients who underwent surgery for improving vision, 8 patients had transparent grafts during follow up without vascularization. All eight patients had been treated with acyclovir and mycophenolate mofetil. In one patient who had no systemic treatment recurrence and graft rejection was observed. Only one of the surgeries performed in acute stage of inflammation resulted in a properly healed transparent graft without recurrence and rejection. In this patient acyclivir and mycophenolate mofetil therapy had been given previously. In two cases the preventive - full or partial - systemic treatment had no effect. The visual acuity improved in all cases. In three patients visual acuity was influenced by some other factors as well.
  
  
  CONCLUSIONS
  The systemic acyclovir and mycophenolat mofetil therapy is fairly successful in perforating keratoplasty due to herpes simplex infection. Acyclovir decreases the risk of recurrence, while mycophenolate mofetil may prevent graft rejection. The timing of surgery is decisive; it leads to better results when performed in a scarred, noninflammatory state.
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar Szemészeti Klinika Budapest Mária u. 39. 1085.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Süveges
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar Szemészeti Klinika Budapest Mária u. 39. 1085.
authors.forename: Ágnes
authors.initials: Á
authors.lastname: Füst
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar Szemészeti Klinika Budapest Mária u. 39. 1085.
authors.forename: László
authors.initials: L
authors.lastname: Imre
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016849:Keratitis, Herpetic / Q000188:drug therapy* / Q000517:prevention & control / Q000601:surgery; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D000212:Acyclovir
keywords: herpes simplex keratitis; perforating keratoplasty; perforáló keratoplasztika; postoperative treatment; posztoperatív terápia