September 23, 2013
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Recurring endotheliitis after keratoplasty linked to cytomegalovirus, study finds

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Asian patients who tested positive for cytomegalovirus were prone to recurring corneal endotheliitis after corneal transplantation, despite preoperative antiviral treatment, according to a study.

The retrospective study included 32 eyes of 31 patients who underwent corneal transplantation for irreversible corneal compensation secondary to endotheliitis.

Investigators performed preoperative aqueous polymerase chain reaction (PCR) analysis to test for viruses. Evidence of CMV was found in five eyes; 27 eyes had no evidence of CMV or other viruses.

CMV-positive patients received topical corticosteroids, oral valganciclovir 900 mg and topical ganciclovir 0.15% for 6 weeks before surgery. Corneal transplantation was performed after ocular inflammation resolved and eyes were quiet for at least 6 months.

Endotheliitis recurred in three CMV-positive eyes (60%) and two non-CMV eyes (7.4%) within 1 year after corneal transplantation; the difference was statistically significant (P < .01). Recurrence occurred at a median of 10 months postoperatively in CMV-positive eyes.

All CMV-positive eyes with recurrent endotheliitis had clear grafts for a median 21 months after anti-CMV treatment with topical ganciclovir and oral valganciclovir.

Disclosure: The study authors report no relevant financial disclosures.