Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.ajo.2013.03.020
Title: Outcomes of corneal transplantation for irreversible corneal decompensation secondary to corneal endotheliitis in Asian eyes
Authors: Ang, M.
Sng, C.C.A.
Chee, S.-P.
Tan, D.T.H.
Mehta, J.S. 
Issue Date: Aug-2013
Citation: Ang, M., Sng, C.C.A., Chee, S.-P., Tan, D.T.H., Mehta, J.S. (2013-08). Outcomes of corneal transplantation for irreversible corneal decompensation secondary to corneal endotheliitis in Asian eyes. American Journal of Ophthalmology 156 (2) : 260-266.e2. ScholarBank@NUS Repository. https://doi.org/10.1016/j.ajo.2013.03.020
Abstract: Purpose: To describe outcomes of corneal transplantation for irreversible corneal decompensation from corneal endotheliitis in Asian eyes. Design: Retrospective, observational case series. Methods: We reviewed consecutive patients with corneal endotheliitis (32 eyes of 31 subjects) who underwent keratoplasty (January 1, 2008-December 1, 2009). All eyes had preoperative aqueous polymerase chain reaction (PCR) analysis for viruses, including cytomegalovirus (CMV). CMV-positive patients were treated preoperatively with topical corticosteroids and anti-CMV treatment (oral valganciclovir 900 mg twice daily, topical ganciclovir 0.15% 5 applications per day, for 6 weeks) with complete resolution of ocular inflammation, and quiescence for at least 6 months before corneal transplantation. Our main outcome measure was recurrence of endotheliitis within 1 year after corneal transplantation. Results: Five eyes were CMV positive; the remaining 27 eyes were negative for all viruses on PCR analysis. CMV-positive patients had a higher rate of recurrence of endotheliitis within 1 year after corneal transplantation, compared with CMV-negative eyes (60% vs 7.4%, P =.01). The CMV-positive eyes had recurrent endotheliitis at a median of 10 months (range 3-11 months) after corneal transplantation. After successful anti-CMV treatment, all 5 CMV-positive eyes then continued to have clear grafts for a median duration of 21 months (range 13-44 months). Conclusion: Our study suggests that Asian patients with corneal endotheliitis may benefit from preoperative aqueous PCR analysis before corneal transplantation. Such patients were more likely to have a recurrence of endothelial inflammation if they were CMV positive preoperatively, despite successful anti-CMV treatment before surgery. © 2013 Elsevier Inc. All rights reserved.
Source Title: American Journal of Ophthalmology
URI: http://scholarbank.nus.edu.sg/handle/10635/110604
ISSN: 00029394
DOI: 10.1016/j.ajo.2013.03.020
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