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Possible association between viral infection and poor survival of the corneal graft after penetrating keratoplasty in patients with congenital corneal opacity: a cohort study
  1. Sen Miao1,
  2. Qi Lin2,
  3. Xu Li3,
  4. Lu Zhao3,
  5. Zhiqiang Pan3
  1. 1 Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
  2. 2 Department of Ophthalmology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
  3. 3 Department of Ophthalmology, Beijing Ophthalmology and Visual Science Key laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical Unversity, Beijing, China
  1. Correspondence to Dr Zhiqiang Pan, Beijing Tongren Hospital, Beijing, Beijing, China; panyj0526{at}


Background Congenital corneal opacity (CCO) is a rare disorder. Penetrating keratoplasty (PK) is the main surgical option for CCO, but many factors affect graft survival. Therefore, this study aimed to perform a virological examination of CCO specimens after PK to explore the relationship between virological factors and graft survival after PK.

Methods This prospective study included consecutive patients (<6 months of age) diagnosed with CCO and treated with PK at Beijing Tongren Hospital from August 2017 to January 2018. Next-generation sequencing was used to detect viral DNA in the CCO specimens. The survival of the primary graft was analysed using the Kaplan-Meier method.

Results Overall, 24 eyes of 24 infants were treated with PK during the study period. The mean age at surgery was 4.8±1.1 months. Epstein-Barr virus DNA was detected in two specimens, varicella-zoster virus DNA in one specimen, herpes simplex virus DNA in three specimens and cytomegalovirus DNA in one specimen. In the virus-positive group, only one (14.3%) graft remained clear during follow-up. In contrast, in the virus-negative group (n=17), 13 (76.5%) grafts were still clear at the last follow-up. The mean survival of the grafts in the virus-positive group was significantly shorter than in the virus-negative group (11.0±9.8 months vs 27.1±7.7, p<0.001).

Conclusion The presence of viral DNA in CCO specimens might be associated with poor graft survival after PK.

  • cornea

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors ZP is responsible for the overall content as guarantor. SM and ZP carried out the studies, participated in collecting data, statistical analysis and drafted the manuscript. QL participated in acquisition, analysis or interpretation of data and participated in its design. XL and LZ participated in acquisition and interpretation of data. All authors read and approved the final manuscript.

  • Funding This study was funded by Beijing Municipal Administration of Hospitals Incubating Program in China (PX2019045).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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