Cytomegalovirus keratitis after penetrating keratoplasty

TitleCytomegalovirus keratitis after penetrating keratoplasty
Publication TypeJournal Article
Year of Publication1995
AuthorsWehrly SR, Manning FJ, Proia AD, Burchette JL, Foulks GN
Pagination628 - 33
Date PublishedNov
ISSN0277-3740 (Print) 0277-3740 (Linking)
Accession Number8575188
KeywordsAnti-Inflammatory Agents / administration & dosage, Antibodies, Monoclonal, Antigens, Viral / analysis, Cornea / pathology / surgery / virology, Corneal Stroma / pathology / virology, Cyclosporine / administration & dosage, Cytomegalovirus / immunology, Cytomegalovirus Infections / *etiology / pathology, Eye Infections, Viral / *etiology / pathology, Female, Graft Rejection / drug therapy / etiology, Humans, Immunoenzyme Techniques, Immunosuppressive Agents / administration & dosage, Keratitis / pathology / *virology, Keratoplasty, Penetrating / *adverse effects, Middle Aged, Ophthalmic Solutions, Prednisolone / administration & dosage, Reoperation

We report the development of cytomegalovirus (CMV) keratitis in the penetrating keratoplasty of a 59-year-old human immunodeficiency virus-negative woman after uncomplicated corneal transplantation. Immunosuppression with topical cyclosporine A 2% in corn oil and topical prednisolone acetate 1% suspension was used postoperatively. The 15-month postoperative course was complicated by multiple episodes of endothelial rejection, medically controlled elevated intraocular pressure, polymicrobial bacterial (coagulase-negative staphlococcus and alpha-hemolytic streptococcus) keratitis, and endothelial plaque formation with associated hypopyon and epithelial defect. The graft failed and penetrating keratoplasty was repeated. Cytomegalovirus infection of superficial keratocytes in a region of scarring was identified in histological sections stained with hematoxylin and eosin and confirmed using mouse monoclonal anti-cytomegalovirus antibodies. Excision of the diseased corneal button with no additional treatment appears to have been curative. Low-grade keratitis was the only manifestation of the CMV infection, and it has not recurred 6 months postoperatively.

URLinternal-pdf://Wehrly - CMV-3364790785/Wehrly - CMV.pdf
Notify Library Reference ID1615

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