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Incidence of Cytomegalovirus Infection After Repeat Keratoplasty and Associated Rate of Graft Failure.

Authors :
Zang, Yunxiao
Zhao, Yaning
Peng, Rongmei
Xiao, Gege
Liu, Xiaozhen
Qu, Yi
Zhang, Xuanjun
Zhang, Jiaxin
Hong, Jing
Source :
Ophthalmology & Therapy. Jul2024, Vol. 13 Issue 7, p1967-1980. 14p.
Publication Year :
2024

Abstract

Introduction: The aim of this work was to compare the prognosis and characteristics of patients with Cytomegalovirus (CMV) infection (CMV+) with those of patients without virus infection (Virus–) undergoing repeat keratoplasty. Methods: This prospective propensity score-matched cohort study enrolled patients who underwent repeat keratoplasty for graft failure at the Peking University Third Hospital between January 2016 and May 2022. Patients with prior viral keratitis before the first keratoplasty were excluded. The primary outcome measure was the graft failure rate. The secondary outcome measures included the anterior segment characteristics, intraocular pressure (IOP), and endothelial cell density. Results: Ninety-four matched patient pairs were included. The graft failure rate in the CMV+ group (71%) was higher than that in the Virus– group (29%) (P < 0.001). CMV infection in the cornea increased the risk of repeat graft failure and shortened the median survival time (hazard ratio, 3.876; 95% confidence intervals, 2.554–5.884; P < 0.001). The characteristics of graft failure included exacerbation of ocular surface inflammation, neovascularization, and opacification. Epithelial defects, high IOP, and endothelial decompensation were observed at an increased frequency in the CMV+ group (all P < 0.005). Recurrent CMV infection presented as early endothelial infection in the CMV+ group. Recurrence of CMV infection was confined to the graft endothelium without involving the stroma and epithelium post-repeat endothelial keratoplasty. Conclusions: CMV infection post-keratoplasty leads to persistent endothelial damage and graft opacification and significantly increases the risk of repeat graft failure. Localized recurrence of CMV infection in the endothelial grafts underscores the importance of monitoring and treatment. Trial Registration: Chictr.org.cn, ChiCTR1800014684. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
21938245
Volume :
13
Issue :
7
Database :
Academic Search Index
Journal :
Ophthalmology & Therapy
Publication Type :
Academic Journal
Accession number :
177897855
Full Text :
https://doi.org/10.1007/s40123-024-00968-1