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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/46404
Title: Topical ganciclovir treatment post-Descemet's stripping automated endothelial keratoplasty for patients with bullous keratopathy induced by cytomegalovirus
Authors: Koji Kitazawa
Passara Jongkhajornpong
Tsutomu Inatomi
Noriko Koizumi
Kanae Kayukawa
Koichi Wakimasu
Chie Sotozono
Shigeru Kinoshita
Kyoto Prefectural University of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Doshisha University
Ophthalmology
Keywords: Medicine;Neuroscience
Issue Date: 1-Sep-2018
Citation: British Journal of Ophthalmology. Vol.102, No.9 (2018), 1293-1297
Abstract: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Background/aims To investigate the efficacy of topical ganciclovir (GCV) for preventing disease recurrence and improving the surgical outcome post-Descemet's stripping automated endothelial keratoplasty (DSAEK) in patients with cytomegalovirus (CMV) endotheliitis. Methods This prospective, non-comparative case series study involved six eyes of six patients with endothelial decompensation due to CMV endotheliitis who underwent DSAEK, followed by a continuous, four to six times daily, topical administration of 0.5% GCV. Patient demographics, clinical history, and preoperative and postoperative examination (including any recurrence of CMV endotheliitis post-DSAEK), best corrected visual acuity (BCVA), intraocular pressure (IOP), graft survival rate and endothelial cell density (ECD) were examined. Results No recurrence of CMV endotheliitis was detected post-DSAEK. The mean follow-up period was 40 months (range, 12-60 months). The mean preoperative BCVA was 1.52±0.68 LogMAR (range, 0.52-2.40 LogMAR), yet it had significantly improved to 0.15±0.16 LogMAR (range: '0.08 to 0.30 LogMAR) by 1 year postoperative (P<0.01). In all patients, IOP was well controlled (10-20 mm Hg) postsurgery. The mean preoperative donor ECD was 2692±177 cells/mm 2, and the mean postoperative ECD was 1974, 1771 and 1174 cells/mm 2 for the ECD loss of 26%, 33% and 54% at 6, 12 and 36 months, respectively. No adverse effects were observed associated with the long-term topical administration of GCV. Conclusion The continuous topical application of 0.5% GCV was found to be effective for preventing the recurrence of CMV endotheliitis, and it provided the optimal mid-term clinical outcomes post-DSAEK in patients with CMV endotheliitis. Trial registration number UMIN000026746
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85051944956&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/46404
ISSN: 14682079
00071161
Appears in Collections:Scopus 2018

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