Br J Ophthalmol
Br J OphthalmolMay 2025Journal Article

Predictors of cytomegalovirus corneal endotheliitis postcorneal transplantation.

Epidemiology & Genetics

Summary

CMV corneal endotheliitis developed postcorneal transplantation with coin-shaped lesions. Careful postoperative follow-up, especially within the first 12 months after surgery, is necessary for patients with a history of glaucoma or anterior uveitis.

Abstract

PURPOSE

This study was designed to investigate risk factors for the development of cytomegalovirus (CMV) corneal endotheliitis following corneal transplantation.

METHODS

We retrospectively analysed 1225 corneal transplants for bullous keratopathy between 2011 and 2021. 31 cases who were administered the treatment of CMV corneal endotheliitis preoperatively were excluded, and 1194 cases were analysed for risk factors for the development of CMV corneal endotheliitis following corneal transplantation.

RESULTS

Among 1194 cases, 15 cases (1.26%) occurred CMV corneal endotheliitis after corneal transplantation. Coin-shaped lesion or keratoprecipitates were observed in 100% of cases. Postoperatively, the mean onset of CMV corneal endotheliitis was 9.9±12.2 months, with 12 eyes (80.0%) within the first 12 months. Multivariate analysis adjusted for potential confounding factors revealed a gender (male, OR (8.42, 95%

CI

2.19 to 56.00), the previous history of anterior uveitis (OR: 25.31, 95%

CI

8.22 to 95.19) and the previous history of glaucoma (OR: 6.25, 95%

CI

1.17 to 115.90) were significantly associated with the development of postoperative CMV corneal endotheliitis. The maternal proportion Ryan multiple comparison tests revealed that dual previous history with glaucoma and anterior uveitis significantly enhanced the development of postoperative CMV corneal endotheliitis (p<0.001).

CONCLUSIONS

CMV corneal endotheliitis developed postcorneal transplantation with coin-shaped lesions. Careful postoperative follow-up, especially within the first 12 months after surgery, is necessary for patients with a history of glaucoma or anterior uveitis.

Keywords

CorneaInfectionOcular surfaceRisk Factors

Discussion

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