Acta Med. 2020, 63: 150-158
Corneal Graft Success Rates in HSV Keratitis: A Systematic Review
, Eleftherios Chatzimichael, Eirini-Kanella Panagiotopoulou, Sergios Taliantzis, Aristeidis Konstantinidis, Georgios Labiris
Department of Ophthalmology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
Received July 15, 2020
Accepted October 2, 2020
Herpes Simplex Virus (HSV) has worldwide prevalence. The primary objective of this systematic review was to compare penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) regarding the efficacy and complications of the treatment of corneal scarring caused by herpes simplex keratitis. Out of the 469 articles identified during the combined search of the literature based on the PubMed and Cochrane libraries, 10 retrospective and 2 prospective studies published from January 2010 to December 2019 were included. The study outcomes indicated that both surgical approaches resulted in a comparable improvement of visual acuity (VA). However, DALK demonstrated fewer complications in the majority of studies. Higher graft survival rates were associated with higher acyclovir (ACV) doses (above 800 mg/day), topical steroid and antibiotic drops. In conclusion, in terms of postoperative VA, both PK and DALK demonstrate comparable efficacy. However, DALK, which is applied in less severe HSK cases, is associated with fewer complications and better graft survival rates. High dosages of ACV, topical steroids and antibiotics contribute significantly to improved postoperative outcomes.
Keywords
herpes simplex virus, herpes simplex keratitis, penetrating keratoplasty, deep anterior lamellar keratoplasty, systematic review.
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Copyright
This is an open-access article distributed under the terms of the Creative Commons Attribution License.
