Publication: Topical ganciclovir treatment post-Descemet's stripping automated endothelial keratoplasty for patients with bullous keratopathy induced by cytomegalovirus
Issued Date
2018-09-01
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ISSN
14682079
00071161
00071161
Other identifier(s)
2-s2.0-85051944956
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Mahidol University
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SCOPUS
Bibliographic Citation
British Journal of Ophthalmology. Vol.102, No.9 (2018), 1293-1297
Suggested Citation
Koji Kitazawa, Passara Jongkhajornpong, Tsutomu Inatomi, Noriko Koizumi, Kanae Kayukawa, Koichi Wakimasu, Chie Sotozono, Shigeru Kinoshita Topical ganciclovir treatment post-Descemet's stripping automated endothelial keratoplasty for patients with bullous keratopathy induced by cytomegalovirus. British Journal of Ophthalmology. Vol.102, No.9 (2018), 1293-1297. doi:10.1136/bjophthalmol-2017-311145 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/46404
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Title
Topical ganciclovir treatment post-Descemet's stripping automated endothelial keratoplasty for patients with bullous keratopathy induced by cytomegalovirus
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