Ficker L A, Kirkness C M, Rice N S, Steele A D
Cornea Clinic, Moorfields Eye Hospital, London.
Eye (Lond). 1988;2 ( Pt 4):400-8. doi: 10.1038/eye.1988.73.
A previously reported cohort of patients was reviewed after mean follow-up of 10.9 years. The overall probability of survival was 45%, but first grafts had a greater probability of survival than second (P = 0.12) or further (P = 0.19) grafts. Preoperative active keratitis adversely affected survival (P = 0.123). The major cause of failure was graft rejection. Regrafts were more likely to fail from rejection episodes (P = 0.0005). Antiviral prophylaxis improved the outcome for rejection (P = 0.005) and reduced the incidence of HSK recurrence complicating rejection. Suppurative keratitis occurred in 12.4% of grafts as a complication of epitheliopathy including HSK recurrence. The outcome in these cases was particularly poor. Loose continuous graft sutures resulted in graft failure in 10.6% of grafts which may be improved by using interrupted suturing. Our results suggest the longterm prognosis for grafting in herpes simplex keratitis are not as good as may have been predicted from previous analyses.
对先前报告的一组患者进行了回顾，平均随访时间为10.9年。总体生存概率为45%，但首次移植的生存概率高于第二次（P = 0.12）或后续（P = 0.19）移植。术前活动性角膜炎对生存有不利影响（P = 0.123）。失败的主要原因是移植排斥。再次移植更有可能因排斥反应而失败（P = 0.0005）。抗病毒预防改善了排斥反应的结果（P = 0.005），并降低了与排斥反应并发的单纯疱疹性角膜炎复发的发生率。12.4%的移植发生化脓性角膜炎，这是包括单纯疱疹性角膜炎复发在内的上皮病变的并发症。这些病例的结果特别差。10.6%的移植因连续移植缝线松动导致移植失败，采用间断缝合可能会改善这种情况。我们的结果表明，单纯疱疹性角膜炎移植的长期预后不如先前分析所预测的那样好。
