%0 Journal Article
%T Repeat corneal graft failure due to graft-to-host herpetic infection
%A Zisis Gatzioufas
%A Andrea Hasenfus
%A Balasz Gyongyossy
%A Evangelos Stavridis
%A Marlies Sauter
%A Sigrun Smola
%A Berthold Seitz
%J Journal of Ophthalmic Inflammation and Infection
%D 2013
%I Springer
%R 10.1186/1869-5760-3-24
%X Under the suspicion of herpetic eye disease, we administered topical and systemic anti-herpetic treatment after the second repeat keratoplasty. The postoperative course was uneventful, and the corneal graft is clear, until recently. Immunohistochemistry and DNA-polymerase chain reaction were negative for herpes simplex virus-1 (HSV-1) in the host cornea, but they detected HSV-1 in both transplanted corneal grafts, thereby supporting our clinical hypothesis that graft-to-host HSV-1 infection elicited this chain reaction of complications in our patient.This clinical report illustrates in a unique way the dramatic impact an unsuspected herpetic infection in the corneal graft in cases of keratoplasty may have and underscores the necessity of suspecting and adequately treating these distinct cases.Several authors have reported the occurrence of herpetic keratitis after penetrating keratoplasty in patients with no history of herpetic disease [1-3]. It has been hypothesized that graft-to-host transmission of herpes simplex virus 1 (HSV-1) may cause herpetic keratitis, which is described as ¡®newly acquired¡¯ keratitis [2,4]. However, reactivation of a latent HSV-1 infection may also account for persisting corneal epithelial defects or even corneal graft failure after penetrating keratoplasty [5]. Hereby, we present a unique case of repeat corneal graft failure after penetrating keratoplasty, which is associated with graft-to-host HSV-1 infection.A 45-year-old female patient presented in our outpatient clinic in June 2008, complaining of gradual deterioration of visual acuity in the left eye (OS) for 1 year. She had no medical history and received no medication. Best-corrected visual acuity (BCVA) was 9/10 in the right eye (OD) and 1/20 OS. Intraocular pressure (IOP) was 14 mmHg OD and 15 mmHg OS. Objective refraction was +2.5/£¿1.25/55¡ã OD and +1.5/£¿2.25/45¡ã OS. Slit-lamp examination revealed central corneal irregularity with marked thinning of the paracentral cornea OS (Figu
%K Penetrating keratoplasty
%K Herpes simplex virus
%K HSV
%K Corneal graft failure
%K DNA-PCR
%K Immunohistochemistry
%U http://www.joii-journal.com/content/3/1/24