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August 1989

Oral Acyclovir Reduces the Incidence of Recurrent Herpes Simplex Keratitis in Rabbits After Penetrating Keratoplasty

Author Affiliations

From the National Eye Institute, Bethesda, Md (Dr Beyer), and the Departments of Ophthalmology (Drs Beyer, Hill, Rose, and Schanzlin and Ms Beyer) and Pediatrics (Dr Arens), St Louis (Mo) University School of Medicine. Dr Beyer is now with the LSU Eye Center, New Orleans, La.

Arch Ophthalmol. 1989;107(8):1200-1205. doi:10.1001/archopht.1989.01070020266036

• To determine if acyclovir sodium prevents postoperative herpes simplex virus type 1 (HSV-1) recurrences, 21 rabbits harboring latent HSV-1 underwent uniocular autograft penetrating keratoplasty. All operated-on eyes were treated with topical and subconjunctival dexamethasone sodium phosphate. Ten of the 21 rabbits also received oral acyclovir (intravenous acyclovir was given at the time of surgery). Postoperatively, 9 (82%) of 11 operatedon eyes in rabbits not treated with acyclovir had positive HSV-1 ocular cultures. In acyclovir-treated rabbits, however, none of the 10 operated-on eyes had positive ocular cultures. In addition, 9 (82%) of 11 of the operated-on eyes had geographic ulcers develop in the non-acyclovir-treated rabbits, compared with 1 (10%) of 10 in the acyclovir-treated rabbits. Finally, stromal keratitis appeared in 5 (56%) of 9 of the operated-on eyes in non-acyclovir-treated rabbits and 1 (12%) of 8 of the operated-on eyes in acyclovirtreated rabbits. The results of this study indicate that acyclovir significantly lowered the incidence of HSV-1 ocular shedding, geographic ulceration, and stromal keratitis in a rabbit autograft penetrating keratoplasty model.