Clinical Manifestations and Long-term Outcomes of Endothelial Keratoplasty in Patients with Proven VZV-related Endothelial Decompensation

Ocul Immunol Inflamm. 2023 Feb;31(2):348-354. doi: 10.1080/09273948.2022.2028292. Epub 2022 Jan 20.

Abstract

Purpose: To report the clinical manifestations, postoperative complications and long-term outcomes of endothelial keratoplasty in VZV-related endothelial decompensation.

Methods: In this retrospective study, thirteen eyes undergoing endothelial keratoplasty (EK) for VZV-related endothelial decompensation were compared with controls for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy.

Results: Twelve patients did not have typical dermal pain or blisters. Ten patients had obvious iris abnormalities. Glaucoma was noted in eight patients before surgery. The best spectacle-corrected visual acuity improved from 1.12 ± 0.47 to 0.39 ± 0.43 (p = .002), whereas endothelial cell (EC) loss was 65% ±15% at 12 months that higher than that in the controls (p < .05). Postoperative complications included graft detachment (2/13), recurrence of endotheliitis (3/13), neurotrophic ulcer (1/13) and scleritis (1/13).

Conclusions: The onset of VZV-related endothelial decompensation is generally insidious. Iris segmental atrophy, glaucoma and pigment KPs are highly suspected to be associated with VZV. EK is a reasonable option to rehabilitate vision.

Keywords: VZV-related endothelial decompensation; clinical outcome; endothelial keratoplasty.

MeSH terms

  • Descemet Stripping Endothelial Keratoplasty*
  • Endothelium, Corneal
  • Fuchs' Endothelial Dystrophy*
  • Glaucoma* / surgery
  • Humans
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity