Klin Monbl Augenheilkd 2010; 227(5): 400-406
DOI: 10.1055/s-0029-1245375
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Perforierende Keratoplastik bei Hornhautinfektionen durch Herpes-simplex-Virus und Varizella-zoster-Virus

Penetrating Keratoplasty in Corneal Infections with Herpes Simplex Virus and Varizella Zoster VirusF. Birnbaum1 , T. Reinhard1
  • 1Universitäts-Augenklinik Freiburg
Further Information

Publication History

Eingegangen: 3.12.2009

Angenommen: 25.3.2010

Publication Date:
20 May 2010 (online)

Zusammenfassung

Perforierende Keratoplastiken bei Hornhautnarben durch rezidivierende Herpes-simplex-Virus-Entzündungen werden recht häufig durchgeführt. Deutlich seltener erfordern persistierende Infektionen durch das Varizella-zoster-Virus eine Hornhauttransplantation. Durch die meist vorliegenden Vaskularisationen und die Gefahr der rezidivierenden Virusreplikation gehören die Hornhauttransplantationen bei Herpes-simplex- und Varizella-zoster-Viren zur Gruppe der Risikokeratoplastiken. Durch Verbesserungen der medikamentösen Nachbehandlung mit Virustatika und systemischen Immunsuppressiva ließ sich die Prognose in den vergangenen Jahren deutlich optimieren. In dieser Übersichtsarbeit sollen die Besonderheiten bei der Indikationsstellung und bei der Nachbehandlung dargestellt werden.

Abstract

Penetrating keratoplasties due to herpetic corneal scars are more often performed compared to persisting Varizella zoster virus infections, which are quite seldom. Penetrating keratoplasties in herpetic corneas are risk keratoplasties due to the vascularisation and the risk of recurrent virus replication. The prognosis in these corneal transplantations has been improved in recent years due to better postoperative medical treatment with virustatics and systemic immunosuppression. Indications for and treatment following penetrating keratoplasty in herpetic eyes are the topics of this review.

Literatur

  • 1 Sundmacher R. Color atlas of herpetic eye disease – a practical guide to clinical management. Berlin: Springer; 2009
  • 2 Sundmacher R, Wolff M. Four years’ experience with triple procedures in herpes-afflicted eyes.  Ger J Ophthalmol. 1993;  2 65-69
  • 3 Dana M R, Streilein J W. Loss and restoration of immune privilege in eyes with corneal neovascularization.  Invest Ophthalmol Vis Sci. 1996;  37 2485-2494
  • 4 Reinhard T, Sundmacher R, Godehardt E et al. Preventive systemic cyclosporin A after keratoplasty at increased risk for immune reactions as the only elevated risk factor.  Ophthalmologe. 1997;  94 496-500
  • 5 Remeijer L, Maertzdorf J, Doornenbal P et al. Herpes simplex virus 1 transmission through corneal transplantation.  Lancet. 2001;  357 442
  • 6 Robert P Y, Adenis J P, Pleyer U. How „safe” is corneal transplantation? A contribution on the risk of HSV-transmission due to corneal transplantation.  Klin Monatsbl Augenheilkd. 2005;  222 870-873
  • 7 Maier P, Böhringer D, Reinhard T. Clear graft survival and immune reactions following emergency keratoplasty.  Graefes Arch Clin Exp Ophthalmol. 2007;  245 351-359
  • 8 Birnbaum F, Reinhard T, Böhringer D et al. Endothelial cell loss after autologous rotational keratoplasty.  Graefes Arch Clin Exp Ophthalmol. 2005;  243 57-59
  • 9 Birnbaum F, Reinhard T, Ulbricht T et al. Functional results after autologous rotational keratoplasty. A retrospective study.  Ophthalmologe. 2004;  101 54-58
  • 10 Sarnicola V, Toro P. Deep anterior lamellar keratoplasty in herpes simplex corneal opacities.  Cornea. 2010;  29 60-64
  • 11 Eberwein P, Auw-Hadrich C, Birnbaum F et al. Corneal melting after cross-linking and deep lamellar keratoplasty in a keratoconus patient.  Klin Monatsbl Augenheilkd. 2008;  225 96-98
  • 12 Tanure M A, Cohen E J, Grewal S et al. Penetrating keratoplasty for varicella-zoster virus keratopathy.  Cornea. 2000;  19 135-139
  • 13 Böhringer D, Reinhard T. The practicability of HLA matching.  Ophthalmologe. 2007;  104 219-221
  • 14 Böhringer D, Reinhard T, Duquesnoy R J et al. Beneficial effect of matching at the HLA-A and -B amino-acid triplet level on rejection-free clear graft survival in penetrating keratoplasty.  Transplantation. 2004;  77 417-421
  • 15 Böhringer D, Spierings E, Enczmann J et al. Matching of the minor histocompatibility antigen HLA-A1 /H-Y may improve prognosis in corneal transplantation.  Transplantation. 2006;  82 1037-1041
  • 16 Böhringer D, Sundmacher R, Reinhard T. HLA B 27 seems to promote graft failure following penetrating keratoplasties for herpetic corneal scars.  Ophthalmologe. 2007;  104 705-708
  • 17 A controlled trial of oral acyclovir for the prevention of stromal keratitis or iritis in patients with herpes simplex virus epithelial keratitis. The Epithelial Keratitis Trial. The Herpetic Eye Disease Study Group.  Arch Ophthalmol. 1997;  115 703-712
  • 18 Acyclovir for the prevention of recurrent herpes simplex virus eye disease. Herpetic Eye Disease Study Group.  N Engl J Med. 1998;  339 300-306
  • 19 Oral acyclovir for herpes simplex virus eye disease: effect on prevention of epithelial keratitis and stromal keratitis. Herpetic Eye Disease Study Group.  Arch Ophthalmol. 2000;  118 1030-1036
  • 20 Akova Y A, Onat M, Duman S. Efficacy of low-dose and long-term oral acyclovir therapy after penetrating keratoplasty for herpes simplex heratitis.  Ocul Immunol Inflamm. 1999;  7 51-60
  • 21 Barney N P, Foster C S. A prospective randomized trial of oral acyclovir after penetrating keratoplasty for herpes simplex keratitis.  Cornea. 1994;  13 232-236
  • 22 Cheng C K, Chang S W, Hu F R. Acyclovir treatment for linear endotheliitis on grafted corneas.  Cornea. 1995;  14 311-315
  • 23 Garcia D D, Farjo Q, Musch D C et al. Effect of prophylactic oral acyclovir after penetrating keratoplasty for herpes simplex keratitis.  Cornea. 2007;  26 930-934
  • 24 Ghosh S, Jhanji V, Lamoureux E et al. Acyclovir therapy in prevention of recurrent herpetic keratitis following penetrating keratoplasty.  Am J Ophthalmol. 2008;  145 198-202
  • 25 Jansen A F, Rijneveld W J, Remeijer L et al. Five-year follow-up on the effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis.  Cornea. 2009;  28 843-845
  • 26 Kersten A, Sundmacher R, Reinhard T. [Postoperative complications of penetrating keratoplasty in herpes infected eyes. Differential diagnosis, therapy and prognostic significance].  Ophthalmologe. 1997;  94 889-896
  • 27 Simon A L, Pavan-Langston D. Long-term oral acyclovir therapy. Effect on recurrent infectious herpes simplex keratitis in patients with and without grafts.  Ophthalmology. 1996;  103 1399-1404 ; discussion 1404 – 1395
  • 28 Sudesh S, Laibson P R. The impact of the herpetic eye disease studies on the management of herpes simplex virus ocular infections.  Curr Opin Ophthalmol. 1999;  10 230-233
  • 29 Uchoa U B, Rezende R A, Carrasco M A et al. Long-term acyclovir use to prevent recurrent ocular herpes simplex virus infection.  Arch Ophthalmol. 2003;  121 1702-1704
  • 30 Rooij van J, Rijneveld W J, Remeijer L et al. Effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis: a placebo-controlled multicenter trial.  Ophthalmology. 2003;  110 1916-1919 ; discussion 1919
  • 31 Miserocchi E, Modorati G, Galli L et al. Efficacy of valacyclovir vs acyclovir for the prevention of recurrent herpes simplex virus eye disease: a pilot study.  Am J Ophthalmol. 2007;  144 547-551
  • 32 Goldblum D, Bachmann C, Tappeiner C et al. Comparison of oral antiviral therapy with valacyclovir or acyclovir after penetrating keratoplasty for herpetic keratitis.  Br J Ophthalmol. 2008;  92 1201-1205
  • 33 Duan R, Vries R D, Osterhaus A D et al. Acyclovir-resistant corneal HSV-1 isolates from patients with herpetic keratitis.  J Infect Dis. 2008;  198 659-663
  • 34 Birnbaum de F, Böhringer D, Sokolovska Y et al. Immunosuppression with cyclosporine a and mycophenolate mofetil after penetrating high-risk keratoplasty: a retrospective study.  Transplantation. 2005;  79 964-968
  • 35 Birnbaum F, Mayweg S, Reis A et al. Mycophenolate mofetil (MMF) following penetrating high-risk keratoplasty: long-term results of a prospective, randomised, multicentre study.  Eye. 2009;  23 (11) 2063-2070
  • 36 Birnbaum F, Reis A, Reinhard T. Immunosuppression following penetrating keratoplasty.  Ophthalmologe. 2007;  104 371-372
  • 37 Reis A, Reinhard T, Voiculescu A et al. Highly active antiviral and immunosuppressive combination therapy with acyclovir and mycophenolate mofetil following keratoplasty in patients with herpetic eye disease.  Klin Monatsbl Augenheilkd. 2001;  218 183-186
  • 38 Mayer K, Reinhard T, Reis A et al. Synergistic antiherpetic effect of acyclovir and mycophenolate mofetil following keratoplasty in patients with herpetic eye disease: first results of a randomised pilot study.  Graefes Arch Clin Exp Ophthalmol. 2003;  241 1051-1054
  • 39 Neyts J, De Clercq E. Mycophenolate mofetil strongly potentiates the anti-herpesvirus activity of acyclovir.  Antiviral Res. 1998;  40 53-56
  • 40 Garcia D D, Shtein R M, Musch D C et al. Herpes simplex virus keratitis: histopathologic neovascularization and corneal allograft failure.  Cornea. 2009;  28 963-965
  • 41 Bock F, Konig Y, Kruse F et al. Bevacizumab (Avastin) eye drops inhibit corneal neovascularization.  Graefes Arch Clin Exp Ophthalmol. 2008;  246 281-284
  • 42 Maier P, Birnbaum F, Reinhard T. Steam cautery of the cornea in microbial keratitis.  Ophthalmologe. 2008;  105 79-80
  • 43 Heiligenhaus A, Li H, Hernandez Galindo E E et al. Management of acute ulcerative and necrotising herpes simplex and zoster keratitis with amniotic membrane transplantation.  Br J Ophthalmol. 2003;  87 1215-1219
  • 44 Heiligenhaus A, Li H, Yang Y et al. Amniotic membrane transplantation improves experimental herpetic keratitis. Modulation of matrix metalloproteinase-9.  Ophthalmologe. 2004;  101 59-65
  • 45 Seitz B. Amniotic membrane transplantation. An indispensable therapy option for persistent corneal epithelial defects.  Ophthalmologe. 2007;  104 1075-1079
  • 46 Shi W, Chen M, Xie L. Amniotic membrane transplantation combined with antiviral and steroid therapy for herpes necrotizing stromal keratitis.  Ophthalmology. 2007;  114 1476-1481
  • 47 Spelsberg H, Reichelt J A. Amniotic membrane transplantation in proven ulcerative herpetic keratitis: successful anti-inflammatory treatment in time.  Klin Monatsbl Augenheilkd. 2008;  225 75-79
  • 48 Birnbaum F, Maier P, Reinhard T. Intracameral application of corticosteroids for treating severe endothelial rejection after penetrating keratoplasty.  Ophthalmologe. 2007;  104 813-816

PD Dr. Florian Birnbaum

Augenklinik, Universitätsklinik Freiburg

Killianstr. 5

79106 Freiburg

Phone: ++ 49/7 61/2 70 40 01

Fax: ++ 49/7 61/2 70 40 63

Email: florian.birnbaum@uniklinik-freiburg.de

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