Cytomegalovirus keratitis after penetrating keratoplasty.
We report the development of cytomegalovirus (CMV) keratitis in the penetrating keratoplasty of a 59-year-old human immunodeficiency virus-negative woman after uncomplicated corneal transplantation. Immunosuppression with topical cyclosporine A 2% in corn oil and topical prednisolone acetate 1% suspension was used postoperatively. The 15-month postoperative course was complicated by multiple episodes of endothelial rejection, medically controlled elevated intraocular pressure, polymicrobial bacterial (coagulase-negative staphlococcus and alpha-hemolytic streptococcus) keratitis, and endothelial plaque formation with associated hypopyon and epithelial defect. The graft failed and penetrating keratoplasty was repeated. Cytomegalovirus infection of superficial keratocytes in a region of scarring was identified in histological sections stained with hematoxylin and eosin and confirmed using mouse monoclonal anti-cytomegalovirus antibodies. Excision of the diseased corneal button with no additional treatment appears to have been curative. Low-grade keratitis was the only manifestation of the CMV infection, and it has not recurred 6 months postoperatively.
Duke Scholars
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Related Subject Headings
- Reoperation
- Prednisolone
- Ophthalmology & Optometry
- Ophthalmic Solutions
- Middle Aged
- Keratoplasty, Penetrating
- Keratitis
- Immunosuppressive Agents
- Immunoenzyme Techniques
- Humans
Citation
Published In
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Reoperation
- Prednisolone
- Ophthalmology & Optometry
- Ophthalmic Solutions
- Middle Aged
- Keratoplasty, Penetrating
- Keratitis
- Immunosuppressive Agents
- Immunoenzyme Techniques
- Humans