Effect of recipient lamellar keratectomy on corneal topography in penetrating keratoplasty

Recipient tissue weakness is thought to be a cause of the high residual astigmatism that may follow penetrating keratoplasty (PK). In a rabbit model, we investigated the topographic effect of a controlled lamellar keratectomy (6 x 3 x 0.25 mm) on the recipient side following PK. Results from 10 animals indicate an overall flattening of 5 D along the axis of the keratectomy--i.e., the axis of recipient tissue weakness. Our results indicate that recipient corneal integrity may be a factor in corneal transplant topography.

Cytopathogenicity, drug susceptibility, and thymidine kinase activity of a retinovirulent herpes simplex virus type 2

We investigated some of the biological and biochemical characteristics of a neuroinvasive, retinovirulent herpes simplex virus type 2 strain SL (HSV-2[SL]) and compared them with those of a neurovirulent, nonretinovirulent HSV-2 (186). HSV-2(SL) was shown to spread rapidly and produce large syncytium in vitro. HSV-2(SL) and HSV-2(186) were equally susceptible to acyclovir (ACV) and thymine arabinoside (Ara-T). However, HSV-2(SL) was fourfold and 44-fold more susceptible than HSV-2(186) to iododeoxyuridine (IUdR) and bromovinyldeoxyuridine (BVDU), respectively. In addition, cytosolic TK from HSV-2(SL)-infected cells phosphorylated 4, 20, and 23,000 times more IUdR, iododeoxycytidine (IdCyD), and Ara-T than the TK of HSV-2(186), respectively. Further, HSV-2(186) TK did not phosphorylate Ara-T, but HSV-2(186) replication was inhibited by Ara-T. These studies indicate that the retinovirulent HSV-2(SL) has a syn phenotype and a TK with broad substrate activity.

Suture patterns and corneal graft rotation in the cadaver eye

Torque and antitorque running sutures as described by Eisner are commonly used in penetrating keratoplasty. We tested the rotational effect of three different 16-bite running suture patterns on eight cadaver eyes, with the following results: (1) the torque pattern rotates the corneal graft counterclockwise by 0.7 +/- 0.1 mm at the wound or 11 degrees; (2) the antitorque pattern rotates the corneal graft clockwise by 0.7 +/- 0.1 mm at the wound or 11 degrees; (3) an intermediate "no torque" pattern, the bites of which form an isosceles triangle, produces no rotational effect. We recommend the use of a "no torque" pattern to minimize corneal graft rotation.

Astigmatism and tissue-shape disparity in penetrating keratoplasty

Tissue-shape disparity between the donor and recipient cornea is a major cause of astigmatism following penetrating keratoplasty. We studied the topographic effects of recipient or donor tissue deficiency (oval donor button or recipient hole) in a penetrating keratoplasty rabbit model. The results demonstrated that a crescent-shape block resection of 0.5 mm x 6.0 mm during penetrating keratoplasty induces 4 to 7 diopters of corneal astigmatism, with the steeper meridian along the axis of tissue deficiency. Corneal topography and vector analysis of astigmatism showed steepening along the axis of tissue deficiency and flattening 90 degrees away.

Isolation of a herpes simplex virus type 2 that is retinovirulent in mice

The virulence of a herpes simplex virus type 2 (HSV-2) isolated from the urine of a patient (SL) with acquired immunodeficiency syndrome (AIDS) and bilateral acute retinal necrosis (ARN), was investigated in mice. The ratio of plaque forming units (PFU) in fibroblasts to the 50% lethal dose (LD50) of HSV-2(SL) in mice was 10 fold more than the PFU to LD50 ratio of a neurovirulent HSV-2, strain 186. Further, HSV-2(SL) caused retinitis with and without lethal encephalitis in mice inoculated intracranially (i.c.). In contrast, mice inoculated with HSV-2(186) died of encephalitis without ocular disease. HSV-2(SL) was isolated from eye and/or brain tissue 1 to 15 days post i.c. inoculation. Ocular disease progressed from an initial mild chorioretinitis on day 8 to total retinal necrosis with panuveitis by day 11 in mice given 10 PFU of HSV-2(SL) i.c. HSV antigen was detected initially in the cells of the optic nerve and spread into the ganglial cells of the nerve fiber layer, the neurosensory cells of the inner nuclear layer, and the cells of the retinal pigment epithelium (RPE) between days 8 and 10. Thus, this study supports the concept that HSV neurovirulence varies between strains and presents a HSV-2 neurotransmission animal model of ARN.