The presence and impact of herpes simplex virus type-1 DNA in recipient cornea and aqueous humour on graft survival following penetrating keratoplasty

Session Details

Session Title: Cornea Surgical: Keratoplasties

Session Date/Time: Monday 16/09/2019 | 16:30-18:00

Paper Time: 16:42

Venue: Free Paper Forum: Podium 1

First Author: : J.Yu Ting TAIWAN

Co Author(s): :    S. Lin   I. Tsai   L. Kuo   C. Tsai   L. Woung                 

Abstract Details

Purpose:

To investigate the presence of herpes simplex virus type 1 (HSV-1) DNA in recipient cornea and aqueous humor of patients receiving penetrating keratoplasty (PKP) using polymerase chain reaction (PCR) test, and whether patients with positive PCR results are at greater risk of developing subsequent graft failure.

Setting:

Zhongxing branch, Taipei City Hospital, Taipei City, Taiwan

Methods:

All patients receiving PKP between 2008 and 2016 operated by one surgeon at our hospital were retrospectively reviewed. PCR testing for the presence of HSV-1 DNA in recipient cornea and aqueous humor was included in the standard practice of PKP during the study period, regardless of the patient’s preoperative conditions. Kaplan–Meier survival analysis and Cox proportional hazard model were used to analyze risk for postoperative graft failure. Hazard ratio (HR) and 95% confidence interval (95% CI) of the risk of developing subsequent graft failure were calculated.

Results:

A total of 90 PKPs were eligible for the final analysis. The positive rate of HSV-1 DNA was 52.22% in recipient cornea and 48.89% in aqueous humor. No significant difference was found in positive rate for HSV-1 DNA on recipient cornea or aqueous humor among different genders, ages, history of ocular herpes disease, history of keratoplasty, and surgical indications. Aqueous humor involvement of HSV-1 resulted in significantly lower 2-year survival rate (58.60% versus 88.40%, P=0.007), with a HR of 2.897 for subsequent graft failure (P=0.005).

Conclusions:

PCR test is an accurate and effective tool for the detection of latent ocular HSV-1 infection, adjunct to thorough history taking and clinical examination. Our real-world data indicates that the presence of HSV-1 DNA in recipient aqueous humor was associated with higher risk of developing subsequent graft failure. Screening for latent HSV-1 infection during PKP allows us to identify patients at potential risk of developing virus-related graft failure, and adequate postoperative treatment could be implemented timely.

Financial Disclosure:

None