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Effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis: a placebo-controlled multicenter trial.

Author(s): van Rooij J, Rijneveld WJ, Remeijer L, Volker-Dieben HJ, Eggink CA, Geerards AJ, Mulder PG, Doornenbal P, Beekhuis WH

Affiliation(s): The Rotterdam Eye Hospital, Schiedamsevest 180, 3011 BH Rotterdam, The Netherlands. drjoe403@xs4all.nl

Publication date & source: 2003-10, Ophthalmology., 110(10):1916-9

Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial

OBJECTIVE: To determine the prophylactic effect of oral acyclovir on the recurrence rate of herpetic eye disease after penetrating keratoplasty. DESIGN: A randomized, double-masked, placebo-controlled multicenter trial. PARTICIPANTS: Sixty-eight consecutive patients (68 eyes) with corneal opacities due to herpetic eye disease who underwent penetrating keratoplasty. INTERVENTION: Oral acyclovir 400 mg twice daily or placebo tablets for 6 months. MAIN OUTCOME MEASURES: The recurrence rate of herpetic eye disease-related events and rejection episodes, proven by viral cell culture or polymerase chain reaction. RESULTS: During the 2-year follow-up period, there were 3 culture-proven herpetic eye disease recurrences in the acyclovir group and 9 in the placebo group. Lifetime survival analysis of the probability of remaining free from recurrence revealed a significantly reduced risk of recurrent herpetic disease in the acyclovir-treated group. CONCLUSION: This study suggests that oral acyclovir effectively prevents herpes-related recurrences after penetrating keratoplasty in herpetic eye disease.

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