Herpes simplex virus in primary graft failure

Arch Ophthalmol. 1997 May;115(5):586-9. doi: 10.1001/archopht.1997.01100150588001.


Objective: To determine the frequency of herpes simplex virus type 1 (HSV-1) in primary corneal graft failures.

Methods: The clinical data submitted about all cases of corneal graft failure on file at the Armed Forces Institute of Pathology, Washington, DC, from the last 25 years (1970-1995) were evaluated. Cases that met the definition of primary graft failure were examined microscopically and analyzed using polymerase chain reaction (PCR) for the DNA of HSV-1.

Results: Three (2.8%) of the 106 cases of graft failure were primary graft failures. The DNA from 2 of the 3 corneal buttons was amplifiable by PCR analysis and results of the PCR analysis and Southern blotting were positive for HSV-1. None of the results of the PCR analysis and Southern blotting of the corneal buttons from the 3 graft failures occurring later than 30 days were positive for HSV-1. Results of the PCR analysis and Southern blotting indicated that 2 of 3 corneal buttons in the control group of clinically suspected herpetic keratitis were positive for HSV-1. The cornea from the first case of primary graft failure showed acute inflammation with stromal necrosis. The cornea in the second case had loss of endothelium without inflammation.

Conclusions: The finding of DNA from HSV-1 in corneal buttons from 2 cases of primary graft failure supports similar observations by Cleator et al and suggests that HSV-1 may be pathogenic in some cases of primary graft failure. A larger study is needed to determine if HSV-1 is a causative factor in primary graft failure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blotting, Southern
  • Cornea / pathology
  • Cornea / virology*
  • Corneal Transplantation*
  • DNA Primers / chemistry
  • DNA, Viral / analysis
  • Female
  • Graft Rejection / pathology
  • Graft Rejection / virology*
  • Herpesvirus 1, Human / genetics
  • Herpesvirus 1, Human / isolation & purification*
  • Humans
  • Keratitis, Herpetic / etiology*
  • Keratitis, Herpetic / pathology
  • Middle Aged
  • Polymerase Chain Reaction


  • DNA Primers
  • DNA, Viral