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Herpes viral polymerase chain reaction in donor corneas

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First Author: A.Katzir ISRAEL

Co Author(s):    A. Katzir   E. Ngwe Nche   D. Wolf   D. Wajnstajn   A. Solomon   I. Lavy     

Abstract Details

Purpose:

The purpose of this trial is to discover the occurrence of Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV) DNA in transplanted corneas using polymerase chain reaction (PCR), and to determine the relationship between latent HSV and VZV with occurrence of herpetic eye disease in recipients and Graft failure.

Setting:

Ongoing study: January 2019 – present, all corneas in this time line from Hadassah Ein Kerem hospital were examined by a PCR test before corneal transplantation in search for HSV and VZV DNA.

Methods:

All corneas were morphologically evaluated before surgery by CellChek® wide field microscopy. Excluded Corneas were detected with infections (HBV, HCV, HIV), a low cell count (under 2,300), corneal scars and abnormal endothelial cell morphology. This corneas were not transplanted and were not checked for HSV/VZV, All eyes transplanted with the donors’ cornea were evaluated and followed for corneal transparency, endothelial cells morphology and number by specular microscopy, signs for ocular inflammation, intraocular pressure and anterior segment OCT for graft attachment.

Results:

HSV-1 DNA was detected in five transplanted corneas out of the 88 that were examined (5.7%). HSV-2 was not detected in any cornea, and VZV in one cornea out of 82 examined (1.2%). 4 of the positive corneas were used in DMEK surgery, one for DMEK + ant vitrectomy + iridoplasty and one as a tectonic graft. 5 of the grafts were cleared and attached after surgery and did not show any of intraocular inflammation during the follow up period of mean 3.6 months (range 1-9 months). The cornea that was used as a tectonic graft resulted in graft failure.

Conclusions:

Herpes viruses, especially HSV-1, may be PCR positive in morphologically normal donor corneas. Further evaluation with bigger sample size and longer follow up time is needed to establish a clinical correlation to donor graft survival and to recipient ocular infection with HSV. Positive samples will be evaluated for reverse transcriptase PCR (rtPCR) to evaluate HSV activity and infectivity.

Financial Disclosure:

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