Abstract
SummaryPurposeTo describe the management of a serious adverse event in a patient undergoing penetrating keratoplasty (PK).Case reportA 68-year-old man underwent PK for an aphakic bullous keratopathy following previous complicated cataract surgery. He had no past history of herpetic disease. Storage of the corneoscleral disc in the transport bottle precluded microscopic examination. After placement of the trephined donor cornea on the open eye of the recipient, a large dendritiform geographic ulcer was noted on the donor cornea. A replacement cornea was used after changing potentially contaminated instruments. Intravenous antiviral treatment was commenced intraoperatively to reduce the risk of infection to the central nervous system. Postoperatively, oral and topical antiviral treatment was commenced and 6 months following surgery the patient developed a geographic corneal ulcer at the graft host interface.ConclusionContainers to transport corneoscleral discs should enable microscopic examination by the surgeon prior to use. High dose systemic antivirals may reduce the risk of herpetic disease involving the posterior segment of the eye and neuroretina in the aphakic eye and spread to the central nervous system.
Highlights
ConclusionContainers to transport corneoscleral discs should enable microscopic examination by the surgeon prior to use
Herpes simplex keratitis (HSK) is one of the major causes of corneal inflammation and corneal blindness, rated just second to trauma in most developed countries [1,2,3]
Clinical reports support the possible transmission of herpes simplex virus type 1 (HSV1) via donor corneas and its role in graft failure [4]
Summary
Containers to transport corneoscleral discs should enable microscopic examination by the surgeon prior to use. Chen Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK. Keywords Herpes Simplex (HSV) · Keratitis · Donor · Recipient · Corneal Transplant. Nach dem Einbringen der präparierten Spenderhornhaut in das offene Auge des Empfängers wurde ein großes dendritisches (geographisches) Ulkus auf der Spenderhornhaut festgestellt. Intraoperativ wurde eine intravenöse antivirale Behandlung begonnen, um das Risiko einer Infektion des Zentralnervensystems zu reduzieren. Sechs Monate nach der Operation entwickelte der Patient ein geographisches Hornhautulkus an der Grenzfläche von Transplantat und Wirtsgewebe. Schlussfolgerung Behältnisse zum Transport von korneoskleralen Scheiben sollten vor deren Verwendung eine mikroskopische Untersuchung durch den Operateur erlauben. K case report sowie die Neuroretina im phakischen Auge betreffen und eine Ausbreitung auf das Zentralnervensystem nach sich ziehen kann. Schlüsselwörter Herpes Simplex (HSV) · Keratitis · Spender · Empfänger · Hornhauttransplantation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Spektrum der Augenheilkunde : Zeitschrift der Osterreichischen Ophthalmologischen Gesellschaft, OOG
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
