FOLLOW-UP ANALYSIS OF PENETRATING PLANNED KERATOPLASTIES AND EMERGENCY KERATOPLASTIES IN HERPES EYES

Background: We evaluated in this retrospective study the impact of our diagnostic and therapeutic regimens - as illustrated by typical clini cal pictures - on the frequency and prognostic values of postkeratopla sty complications in herpes eyes. Patients and methods: Between Novemb er 1986 and June 1994, 112 penetrating keratoplasties (KPS) in herpes eyes were performed, 76 as planned and 36 as emergency procedures. The results were compared with 646 KPS with normal risk. For statistical analysis we used the Kaplan-Meier estimation, and statistical signific ance was tested by the log rank test. Results: After 6 years, 75 % of the grafts in the planned herpes group, 86 % of the a chaud KPS and 76 % of the grafts of the normal-risk group were still clear without sig nificant differences between these three groups. Fifty-four percent of the planned KPS in herpes eyes, 73 % of the a chaud KPS in herpes eye s and 80 % of the normal-risk KPS experienced no immune reaction, with bath herpes groups showing significantly more reactions than the norm al-risk KPS. There was, however, no significant difference in immune r eactions between the two herpes groups. The percentage of grafts with recurrence of herpes simplex virus infection after 6 years was signifi cantly higher in the a chaud group. Conclusions: With proper postopera tive care and optimal management of immunologic and virologic complica tions - but only with this! - the prognosis of penetrating keratoplast ies in herpes eyes equals that of normal risk eyes. An particular, the prognosis is not dependent on whether surgery was performed as a plan ned or as an emergency procedure.