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Case Reports
. 2012 Jun;3(6):42.
doi: 10.1258/shorts.2012.011115. Epub 2012 Jun 27.

Post-phacoemulsification cytomegalovirus corneal endotheliitis diagnosis and management

Abdul-Jabbar Ghauri  1 , Geraint P Williams, Sunil Shah, Philip I Murray, Saaeha Rauz
Affiliations
Case Reports

Post-phacoemulsification cytomegalovirus corneal endotheliitis diagnosis and management

Abdul-Jabbar Ghauri et al. JRSM Short Rep. 2012 Jun.
No abstract available

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Figures

Figure 1
Figure 1
Photograph of the left eye at presentation with the patient seeing 20/60 showing dense corneal stromal oedema (A) and multiple keratic precipitates (B – arrowed). The patient re-presented after interruption of oral valganciclovir treatment with a visual acuity of hand movements at 30cm associated with severe anterior scleritis accompanied by a relapse of CMV endotheliitis (C). Progressive endothelial failure was successfully treated with DSAEK (D)
Figure 2
Figure 2
Strategies for the management and prevention of relapse of CMV endotheliitis.,–  Evidence-based therapeutic algorithm to manage acute manifestations and relapses with or without associated scleritis and sclerokeratitis is illustrated. Implementation of a strict perioperative regime is recommended for any planned intraocular surgical procedure to optimize visual outcome and minimize the risk of surgically induced CMV endotheliitis and sclerokeratitis. Confirmatory qPCR of AqH should be performed, and if corneal transplant surgery is undertaken, excised host endothelium or penetrating keratoplasty tissue should be analysed by qPCR, histopathology and immunofluorescence studies for evidence of active CMV infection i.e. characteristic ‘owl's eyes’.  (AqH, aqueous humour; qPCR, quantitative PCR; CMV, cytomegalovirus;)
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