Sterk C C, Jager M J, Swart-vd Berg M
Department of Ophthalmology, University Hospital Leiden, The Netherlands.
Doc Ophthalmol. 1995;90(1):29-33. doi: 10.1007/BF01203291.
In a retrospective study we evaluated 49 consecutive penetrating keratoplasties for herpes simplex keratitis. Mean follow-up was 44.2 months. Survival analysis with Kaplan-Meier curve showed an overall survival rate (clear graft) of 88% at one year, 76% at two years and 72% at four years postoperatively. Survival analysis showed a recurrence-free survival rate of 72% at one year, 59% at two years and 51% at four years postoperatively. Of the 13 non-primary graft failures, 9 happened in eyes with an HSV recurrence. Recurrence of HSV infection occurred in 18 (39%) eyes at an average of 12.6 months after surgery (range 0.3-46). Five (28%) of the recurrences occurred within two months after the start of steroid treatment for rejection. Nine (50%) of the recurrences cases resulted in a clouded graft at the end of follow-up. 73% of the eyes with a clear graft had a VA of 0.25 or better. We conclude from these data that a recurrence of a herpetic infection following corneal transplantation is the main reason for graft failure in this group.
在一项回顾性研究中，我们评估了49例连续的单纯疱疹性角膜炎穿透性角膜移植术。平均随访时间为44.2个月。采用Kaplan-Meier曲线进行生存分析，结果显示术后1年的总体生存率（植片透明）为88%，2年时为76%，4年时为72%。生存分析显示术后1年无复发生存率为72%，2年时为59%，4年时为51%。在13例非原发性植片失败中，9例发生在有单纯疱疹病毒复发的眼中。单纯疱疹病毒感染复发发生在18只（39%）眼中，平均在术后12.6个月（范围0.3 - 46个月）。其中5例（28%）复发发生在开始使用类固醇治疗排斥反应后的两个月内。9例（50%）复发病例在随访结束时植片混浊。植片透明的眼中73%的视力为0.25或更好。从这些数据我们得出结论，角膜移植术后疱疹感染复发是该组植片失败的主要原因。
