Successful Corneal Autograft After Clearance of Anterior Chamber Cytomegalovirus With Oral Valganciclovir in a Patient With Multiple Failed Corneal Allografts

Purpose: To report a case of recurrent corneal graft failure because of cytomegalovirus (CMV) infection and to demonstrate successful clearance of the virus with oral valganciclovir, confirmed by polymerase chain reaction (PCR) assay. This allowed for a successful corneal autograft to be performed.Methods: Interventional case report.Results: A 90-year-old white man with 4 previous corneal graft failures in his right eye is presented. His visual acuity was no light perception in the left eye subsequent to ocular trauma. His initial penetrating keratoplasty for pseudophakic bullous keratopathy was from a human leukocyte antigen-matched multiorgan donor who was CMV-seropositive. An anterior chamber paracentesis was performed to exclude an infective etiology. CMV was detected on PCR of aqueous humor. After a 12-week course of oral valganciclovir, a repeat aqueous PCR test confirmed the clearance of CMV. A corneal autograft from his left eye was subsequently performed with good outcome.Conclusions: We present a case of successful corneal autograft after clearance of CMV from the anterior chamber (PCR confirmed) in a patient treated with oral valganciclovir.

目的：报告一例因巨细胞病毒（CMV）感染导致角膜移植反复失败的病例，并展示通过口服缬更昔洛韦成功清除病毒，经聚合酶链反应（PCR）检测证实，从而使角膜自体移植得以成功进行。 方法：介入性病例报告。 结果：介绍一名90岁的白人男性，其右眼曾有4次角膜移植失败。他左眼因眼外伤后无光感。他最初因人工晶状体性大泡性角膜病变进行的穿透性角膜移植术，供体是人类白细胞抗原匹配的多器官捐献者，且巨细胞病毒血清学阳性。进行了前房穿刺以排除感染病因。在房水PCR检测中发现了巨细胞病毒。经过12周的口服缬更昔洛韦治疗后，重复的房水PCR检测证实巨细胞病毒已被清除。随后从他的左眼进行角膜自体移植，效果良好。 结论：我们介绍了一例在口服缬更昔洛韦治疗的患者中，前房巨细胞病毒经PCR证实清除后成功进行角膜自体移植的病例。