Document 0657
 DOCN  M9650657
 TI    Cytomegalovirus keratitis after penetrating keratoplasty.
 DT    9605
 AU    Wehrly SR; Manning FJ; Proia AD; Burchette JL; Foulks GN; Department of
       Ophthalmology, Duke University Medical Center,; Durham, North Carolina
       27710, USA.
 SO    Cornea. 1995 Nov;14(6):628-33. Unique Identifier : AIDSLINE MED/96155585
 AB    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.
 DE    Anti-Inflammatory Agents, Steroidal/ADMINISTRATION & DOSAGE  Antibodies,
       Monoclonal  Antigens, Viral/ANALYSIS  Case Report
       Cornea/PATHOLOGY/SURGERY/VIROLOGY  Corneal Stroma/PATHOLOGY/VIROLOGY
       Cyclosporine/ADMINISTRATION & DOSAGE  Cytomegalovirus/IMMUNOLOGY
       Cytomegalovirus Infections/*ETIOLOGY/PATHOLOGY  Eye Infections,
       Viral/*ETIOLOGY/PATHOLOGY  Female  Graft Rejection/DRUG THERAPY/ETIOLOGY
       Human  Immunoenzyme Techniques  Immunosuppressive Agents/ADMINISTRATION
       & DOSAGE  Keratitis/PATHOLOGY/*VIROLOGY  Keratoplasty,
       Penetrating/*ADVERSE EFFECTS  Middle Age  Ophthalmic Solutions
       Prednisolone/ADMINISTRATION & DOSAGE  Reoperation  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).