Herpes simplex virus in primary graft failure
G. C. Cockerham, A. E. Krafft and I. W. McLean
Department of Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC, USA.
OBJECTIVE: To determine the frequency of herpes simplex virus type 1
(HSV-1) in primary corneal graft failures. METHODS: The clinical data
submitted about all cases of corneal graft failure on file at the Armed
Forces Institute of Pathology, Washington, DC, from the last 25 years
(1970-1995) were evaluated. Cases that met the definition of primary graft
failure were examined microscopically and analyzed using polymerase chain
reaction (PCR) for the DNA of HSV-1. RESULTS: Three (2.8%) of the 106 cases
of graft failure were primary graft failures. The DNA from 2 of the 3
corneal buttons was amplifiable by PCR analysis and results of the PCR
analysis and Southern blotting were positive for HSV-1. None of the results
of the PCR analysis and Southern blotting of the corneal buttons from the 3
graft failures occurring later than 30 days were positive for HSV-1.
Results of the PCR analysis and Southern blotting indicated that 2 of 3
corneal buttons in the control group of clinically suspected herpetic
keratitis were positive for HSV-1. The cornea from the first case of
primary graft failure showed acute inflammation with stromal necrosis. The
cornea in the second case had loss of endothelium without inflammation.
CONCLUSIONS: The finding of DNA from HSV-1 in corneal buttons from 2 cases
of primary graft failure supports similar observations by Cleator et al and
suggests that HSV-1 may be pathogenic in some cases of primary graft
failure. A larger study is needed to determine if HSV-1 is a causative
factor in primary graft failure.
