Effect of oral acyclovir after penetrating keratoplasty for herpetic keratitis: a placebo-controlled multicenter trial

Jeroen van Rooij, Wilhelmina J Rijneveld, Lies Remeijer, Henny J M Völker-Dieben, Catrien A Eggink, Annette J M Geerards, Paul G H Mulder, Peter Doornenbal, W Houdijn Beekhuis

Research output: Contribution to journalArticleResearchpeer-review


OBJECTIVE: To determine the prophylactic effect of oral acyclovir on the recurrence rate of herpetic eye disease after penetrating keratoplasty.

DESIGN: A randomized, double-masked, placebo-controlled multicenter trial.

PARTICIPANTS: Sixty-eight consecutive patients (68 eyes) with corneal opacities due to herpetic eye disease who underwent penetrating keratoplasty.

INTERVENTION: Oral acyclovir 400 mg twice daily or placebo tablets for 6 months.

MAIN OUTCOME MEASURES: The recurrence rate of herpetic eye disease-related events and rejection episodes, proven by viral cell culture or polymerase chain reaction.

RESULTS: During the 2-year follow-up period, there were 3 culture-proven herpetic eye disease recurrences in the acyclovir group and 9 in the placebo group. Lifetime survival analysis of the probability of remaining free from recurrence revealed a significantly reduced risk of recurrent herpetic disease in the acyclovir-treated group.

CONCLUSION: This study suggests that oral acyclovir effectively prevents herpes-related recurrences after penetrating keratoplasty in herpetic eye disease.

Original languageEnglish
Pages (from-to)1916-9; discussion 1919
Issue number10
Publication statusPublished - Oct 2003


  • Acyclovir/administration & dosage
  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Antiviral Agents/administration & dosage
  • Corneal Opacity/surgery
  • Double-Blind Method
  • Female
  • Graft Rejection/prevention & control
  • Humans
  • Keratitis, Herpetic/prevention & control
  • Keratoplasty, Penetrating
  • Male
  • Middle Aged
  • Postoperative Complications/prevention & control
  • Secondary Prevention


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