口服阿昔洛韦在单疱病毒性角膜炎行角膜移植术后的应用

Effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis

目的 评价单纯疱疹病毒性角膜炎患者行穿透性角膜移植术后,口服阿昔洛韦预防单纯疱疹病毒性角膜炎复发的疗效。方法 1999年1月至2 0 0 3年12月单纯疱疹病毒性角膜炎5 2例5 2眼行穿透性角膜移植术,术后给予口服阿昔洛韦2 0 0mg 5次/d ,服用2m～3m后减为4 0 0mg 2次/d ,继续服用3m后停止,分析单纯疱疹病毒性角膜炎复发的情况。结果 在口服阿昔洛韦期间,无一例出现单纯疱疹病毒性角膜炎的复发。术后经12m～38m (2 2 .8±9. 6 )的随访,4 9眼植片透明,3眼因排斥反应植片混浊。32眼(6 1 .5 % )最佳矫正视力好于0 . 5 ,4 9眼(94 . 2 % )最佳矫正视力好于0 . 1,3眼(5 . 8% )低于0 . 1。

Objective To evaluate the prophylactic effect of oral acyclovir on the recurrence rate of herpetic keratitis after penetrating keratoplasty.Methods Retrospective study of 52 patients,who underwent penetrating keratoplasty for herpetic keratitis from January 1999 to December 2003,received 200mg of acyclovir orally fifth daily for two or three monthes.After that,acyclovir were tapered to 400mg twice daily for three monthes.Results No recurrence occurred during treatment with oral acyclovir.During the follow-up period of 12～38(22.8±9.6)monthes after PKP,3 eyes experienced graft failure due to immunologic rejection and 49 retained clear grafts.Postoperative visual acuity at last visit was 0.5 or better in 32 eyes,and 0.1 or better in 49 eyes,and less than 0.1 in 3 eyes.Conclusions Oral acyclovir effectively prevents herpes-related recurrences after penetrating keratoplasty in herpetic keratitis.