A retrospective study on the effectiveness of oral acyclovir to prevent herpes simplex recurrence in corneal grafts

Abstract

Objective: A retrospective study of the effectiveness of prophylactic acyclovirn to prevent recurrent infections after penetrating keratoplasty for herpetic macula.

Methods: Follow-up data of 22 patients who where treated prophilactically with oral acyclovir (2 x 400 mg for the first three months after keratoplasy) and of 19 control patients were compared. All patients were operated between 1989-1991 after being free of recurrent Herpes simplex virus (HSV) infections for a minimal period of six months. Survival was defined as the probability of being free of HSV recurrence.

Results: The hazard ratio calculated for the data of a 24 month follow-up was 0.66 (95%Cl: 0.47, 3.8). Survival probabilities at six months were 0.95 for the prophylaxis and 0.74 for the control group (95%Cl of the difference: 0.07, 0.37); after 12 months these proportions were 0.72 and 0.54 respectively (95% Cl: -0.13, 0.47).

Conclusions: In concordance with former studies we conclude that acyclovir may be effective as a prophylaxis in this category of patients. The probability of being free from recurrence was significantly different after six months but not after twelve, possibly indicating that the period of prophylaxis was too short.