title: The outcome of penetrating keratoplasty for corneal scarring due to herpes simplex keratitis.
abstract: To determine the outcomes of penetrating keratoplasty (PK) for treatment of corneal scarring caused by Herpes simplex virus (HSV) keratitis, and whether the corneal scar type affects treatment outcome.
  A retrospective analysis of patients who underwent PK for HSV-related corneal scarring between January 2008 and July 2011 was performed. The patients were categorized into two groups. Group 1 consisted of patients with a quiescent herpetic corneal scar and group 2 consisted of patients who developed a corneal descemetocele or perforation secondary to persistent epithelial defects with no active stromal inflammation. The mean follow-up was 21.30 ± 14.59 months. The main parameters evaluated were recurrence of herpetic keratitis, graft rejection, graft failure, visual acuity, and graft survival rate.
  There were 42 patients in group 1 and 13 in group 2. Preoperative BCVA varied from hand movements to 0.7 logMAR. Postoperatively, 34 patients (61.8%) achieved visual acuity of 0.6 logMAR or more. Recurrence of HSV keratitis was noted in 12 (28.57%) eyes in group 1 and 4 (30.76%) eyes in group 2 (p=0.40). Graft rejection occurred in 4 eyes (9.52%) in group 1 and in 3 (23.07%) eyes in group 2 (p=0.58). The 1-, 2-, and 3-year graft survival rates were 91.9%, 76.0%, and 65.1% in group 1, and 89.5%, 76.0%, and 63.6% in group 2 (p=0.91), respectively.
  Although there were different recurrence and graft rejection rates for two groups, the graft survival rates at 3 years were similar. According to our results, without inflammation, corneal herpetic scarring with a descemetocele or perforation achieved similar graft survival rates with quiescent herpetic corneal scars.
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Altay
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Tamer
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Abdullah Sencer
authors.initials: AS
authors.lastname: Kaya
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Balta
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Burcu
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Firdevs
authors.initials: F
authors.lastname: Ornek
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D065306:Corneal Injuries / Q000601:surgery* / Q000821:virology; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016849:Keratitis, Herpetic / Q000150:complications* / Q000601:surgery; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir