New onset of herpes simplex virus epithelial keratitis after penetrating keratoplasty

Rezende, Renata A.; Uchoa, Uchoandro B.C.; Raber, Irving M.; Rapuano, Christopher J.; Laibson, Peter R.; Cohen, Elisabeth J.

doi:10.1016/j.ajo.2003.09.057

« Previous Next »American Journal of Ophthalmology
Volume 137, Issue 3 , Pages 415-419, March 2004

New onset of herpes simplex virus epithelial keratitis after penetrating keratoplasty☆

Renata A. Rezende, MD
- Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Uchoandro B.C. Uchoa, MD
- Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Irving M. Raber, MD
- Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Christopher J. Rapuano, MD
- Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Peter R. Laibson, MD
- Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Elisabeth J. Cohen, MD
- Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Inquiries to Elisabeth J. Cohen, MD, Wills Eye Hospital, 840 Walnut St, Suite 920, Philadelphia PA 19107, USA; fax: (215) 928 3854

Accepted 24 September 2003.

Abstract

Purpose

To report a series of patients with no previous history of herpes simplex virus (HSV) infection who had new onset of herpetic keratitis after penetrating keratoplasty (PK).

Design

Noncontrolled, retrospective case series.

Methods

We included in the study the patients who had new onset of herpetic keratitis after penetrating keratoplasty for corneal diseases unrelated to HSV infection who were seen at the Cornea Service at Wills Eye Hospital (Philadelphia, Pennsylvania) from January 1996 to December 2002. The diagnosis of HSV epithelial keratitis was based on clinical characteristics of either a classic herpetic dendrite, a geographic ulcer, or a nonhealing epithelial defect that responded only to antiviral therapy.

Results

Fourteen patients were included in the study. Eight of these (57%) had presented with a geographic ulcer whereas six patients (43%) had a classic dendrite. The most common primary corneal disease that led to PK was pseudophakic bullous keratopathy (36%), followed by keratoconus (29%), Fuchs dystrophy (21%), and corneal scar unrelated to HSV (14%).

Conclusions

The ophthalmologist should be aware of the possibility of herpetic keratitis in eyes after PK, even in patients with no previous history of HSV infection.