Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis

Wang, Junyi; Zhao, Ge; Xie, Liping; Chen, Min; Zhao, Jing

doi:10.1007/s00417-012-1947-2

Cited by 19 publications

(10 citation statements)

References 29 publications

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“…Patients with a history of corneal trauma or use of topical glucocorticoids, which are the main risk factors for FK, combined with the clinical features of FK were at high suspicion of having FK . The primary diagnosis of herpes simplex keratitis (HSK) was made according to a history of recurrent episodes of HSK combined with the typical clinical features of HSK . According to the clinical features, 34 patients were at high suspicion of having FK, five were at high suspicion of having HSK, 21 were only primarily diagnosed with corneal ulcer with an unidentified pathogen, and seven were diagnosed with graft ulcer after keratoplasty.…”

Section: Methodsmentioning

confidence: 99%

Rapid and sensitive diagnosis of fungal keratitis with direct PCR without template DNA extraction

Zhao¹,

Zhai²,

Yuan³

et al. 2014

Clinical Microbiology and Infection

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This study was aimed at developing a direct PCR assay without template DNA extraction for the rapid and sensitive diagnosis of infectious keratitis. Eighty corneal scrapings from 67 consecutive patients with clinically suspected infectious keratitis were analysed prospectively. Direct PCR was performed with all scrapings, with specific primers for fungi, bacteria, herpes simplex virus-1 (HSV-1) and Acanthamoeba simultaneously. The results were compared with those obtained from culture, smear, and confocal microscopy. Discrepant results were resolved according to the therapeutic effects of the corresponding antimicrobial drugs. The lowest detection limit of direct PCR was ten copies of each pathogen. Sixty-six scrapings yielded positive results with direct PCR, giving a total positive detection rate of 82.5% (66/80). For 34 patients with high suspicion of fungal keratitis, the positive detection rate of direct PCR was 84.8% (39/46). This rate increased to 91.2% (31/34) when repeated scrapings were excluded, and was significantly higher than the rates obtained with culture (35.3%, 12/34) and smear (64.7%, 22/34) (p <0.001), and was also higher than the rate obtained with confocal microscopy (74.1%, 20/27). The sensitivities for the diagnosis of infectious keratitis with direct PCR and culture were 98.0% and 47.1% (p <0.001), whereas the specificities were 81.8% and 100%, respectively. The time required to complete the entire direct PCR procedure was only 3 h. The direct PCR assay is a rapid diagnostic technique with high sensitivity and specificity for infectious keratitis, and it is expected to have an impact on the diagnosis and treatment of infectious keratitis in the future.

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Section: Methodsmentioning

confidence: 99%

Rapid and sensitive diagnosis of fungal keratitis with direct PCR without template DNA extraction

Zhao¹,

Zhai²,

Yuan³

et al. 2014

Clinical Microbiology and Infection

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“…15 Another report demonstrated that the endothelial cell count 6 and 12 months after DALK was 1908 6 516 cells per square millimeter and 1835 6 491 cells per square millimeter, respectively. 25 Our results showed that the endothelial cell count after a mean follow-up of 50 months was 1738 6 573 cells per square millimeter, even when the preoperative corneal scars reached near the level of DM. These results were encouraging because our follow-up time was much longer than that of the previous studies.…”

Section: Discussionmentioning

confidence: 45%

Long-Term Outcomes of Deep Anterior Lamellar Keratoplasty Treating Posterior Stroma–Implicated Herpetic Corneal Opacities

Ren

Wang

Zheng³

et al. 2016

Cornea

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“…[14] In order to alleviate patient pain, rehabilitate visual acuity, and recover corneal clarity, therapeutic corneal transplantation is needed to eliminate most of the virus existing in the stroma, and thus, reduce the viral load. [20] …”

Section: Discussionmentioning

confidence: 99%

“…This result is consistent with the theory that grafts survive better in inactive HSK when compared with active cases. [34,35] Wang et al [20] demonstrated that HSV antigens were identified in 84.2% of the active cases, but 15.4% of the inactive cases via immunohistochemistry staining. Based on the above information, GCCTs can be effectively and biosafely used with a low rejection and recurrence rate in DALK.…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of deep anterior lamellar keratoplasty using glycerol-cryopreserved corneal tissues for refractory herpetic stromal keratitis

et al. 2016

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The study aimed to evaluate the therapeutic effects of deep anterior lamellar keratoplasty (DALK) using glycerol-cryopreserved corneal tissues (GCCTs) in patients with refractive herpes simplex keratitis (HSK). This article was a retrospective, noncomparative, and interventional case series. Patients with HSK underwent DALK using GCCTs at Shanghai Tongji Hospital from 2012 to 2015. The best spectacle corrected visual acuity, recurrent inflammation, graft status, postoperative central graft thickness, and pre/postoperative complications were detected. The follow-up ranged from 24.4 ± 5.6 months (range: 16–38 months). Overall, the best spectacle corrected visual acuity was increased from HM/10 cm to 0.15 before surgery to 0.41 ± 0.14 (range: 0.1–0.8; P < 0.05) at 12 months postoperatively. Intraoperative microperforation occurred in 4 eyes (14.81%), and rejection episodes were encountered in 3 of 27 eyes (11.1%), and all of the eyes reversed. HSK recurred in 2 eyes (7.41%), 1 eye with repeated recurring HSK, and eventually led to perpetual corneal opacity and the patient refused a retransplantation. The mean entire corneal thickness was 0.519 ± 0.018 mm (range: 0.5–0.56 mm) and the mean graft thickness was 0.405 ± 0.033 mm (range: 0.35–0.47 mm) in the final follow-up. The DALK using GCCTs was proven to be an effective and safe therapy in treating refractory HSK.

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Therapeutic effect of deep anterior lamellar keratoplasty for active or quiescent herpetic stromal keratitis

Cited by 19 publications

References 29 publications

Rapid and sensitive diagnosis of fungal keratitis with direct PCR without template DNA extraction

Rapid and sensitive diagnosis of fungal keratitis with direct PCR without template DNA extraction

Long-Term Outcomes of Deep Anterior Lamellar Keratoplasty Treating Posterior Stroma–Implicated Herpetic Corneal Opacities

Clinical evaluation of deep anterior lamellar keratoplasty using glycerol-cryopreserved corneal tissues for refractory herpetic stromal keratitis

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