PURPOSE: To investigate the long-term effect of oral acyclovir administered during the first 6 months after penetrating keratoplasty (PK) for herpetic eye disease (HED). METHODS: A 5-year follow-up was undertaken for a patient population from a placebo-controlled, randomized trial on acyclovir prophylaxis after keratoplasty. In this former study the effectiveness of oral acyclovir prophylaxis was significant during the first 2 years after keratoplasty. Prospective data such as graft survival, graft clarity, vascularization, infective events, and rejection episodes were obtained from the national keratoplasty follow-up registry. Additional clinical data were derived from the medical charts. RESULTS: For 47 of the original 63 enrolled patients, the 5-year follow-up was completed. Comparing the acyclovir group with the placebo group, we found that with regard to the cumulative clinically evident recurrences, there was a statistically significant lower monthly event rate in the acyclovir group (P = 0.037). There were no statistically significant differences in visual acuity or in the use of oral aciclovir between the two treatment groups. The incidences of graft failure, vascularization, and medication or surgery for glaucoma were too low to analyze differences between the two groups. CONCLUSION: The results of our study suggest that oral acyclovir prescribed during the first 6 months after PK for HED protects against clinically evident HED recurrences during the first 5 years following PK.

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Keywords Acyclovir, Graft survival, Herpes simplex, Herpetic eye disease, Prophylaxis, aciclovir, article, clinical article, controlled study, drug effect, drug efficacy, event free survival, follow up, glaucoma surgery, graft failure, graft infection, graft rejection, graft survival, herpes simplex keratitis, human, incidence, medical record, penetrating keratoplasty, placebo, priority journal, prophylaxis, prospective study, recurrent infection, vascularization, visual acuity
Persistent URL dx.doi.org/10.1097/ICO.0b013e318198399a, hdl.handle.net/1765/17562
Journal Cornea: the journal of cornea and external disease
Jansen, A.F.G, Rijneveld, W.J, Remeijer, L, Völker-Dieben, H.J, Eggink, C.A, Geerards, A.J, … Rooij, J.V. (2009). Five-year follow-up on the effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis. Cornea: the journal of cornea and external disease, 28(8), 843–845. doi:10.1097/ICO.0b013e318198399a