Detection of Cytomegalovirus DNA from Cytomegalovirus Corneal Endotheliitis After Penetrating Keratoplasty

Purpose: To report the detection of cytomegalovirus (CMV) DNA in the cornea of a CMV endotheliitis patient after penetrating keratoplasty (PKP). Case: A 71-year-old man without immunodeficiency developed conical endotheliitis in the right eye. The patient had previously received PKP several times. Polymerase chain reaction (PCR) detected CM V-DNA in the aqueous humor in his affected eye, and we started administration of ganciclovir. There was resolution of the inflammation; however, bullous keratopathy was subsequently noted in the cornea. Additional PKP was performed with perioperative intravenous administration of ganciclovir. The failed graft obtained during the additional PKP was subjected to PCR analysis and histopathological examination. PCR analysis showed CMV-DNA in the failed graft. Little inflammatory change was noted in either the epithelial or stromal layers of the failed graft. With continued ganciclovir treatment, the graft remained clear and no recurrence or rejection occurred until 12 months after the last PKP. Conclusion: Our PCR analysis showed the presence of CMV-DNA within the cornea of the patient with corneal endotheliitis.