Dr. NIDHI GAJENDRAGADKAR

Dr. SAMAR KUMAR BASAK, Dr. SOHAM BASAK

Abstract

Purpose: To use Polymerase chain reaction(PCR) as a preoperative tool for detection of active viral infection in cases of recurrent viral keratitis(RVK).

Methods: Retrospective analytical study from Jan, 2015 to Jun, 2019. In 75 cases having RVK, Aqueous Tap was done for PCR for HSV, VZV and CMV. Oral antivirals were started in positive cases. Patients underwent surgical procedures after PCR was negative.

Results: 75 cases, PCR positive in 51%(38) patients. Mean duration of oral treatment 8.14 months. Recurrence in 7- PCR Positive and in 3 – PCR negative patients. Difference non-significant (p= 0.8). Sensitivity of PCR for no recurrence 81.58% and positive likelihood ratio 0.89 with 95%CI(0.74,1.06). 28 patients underwent surgeries, 68% of which was Endothelial keratoplasty. Recurrence after surgery in 4 cases.

Conclusion: PCR positive cases have higher incidence of HSV Recurrence. Preoperative PCR can be done in RVK and before starting long term oral antiviral to prevent recurrence.