Newly acquired herpes simplex virus keratitis after penetrating keratoplasty.
BACKGROUND
After penetrating keratoplasty for reasons unrelated to herpes simplex virus (HSV) keratitis, any nonspecific epithelial defect may still be caused by HSV. The purpose of this study is to determine the incidence of newly acquired herpetic keratitis and to assess contributing factors.


METHODS
The authors retrospectively studied the results of 2398 penetrating keratoplasties performed between 1980 and 1995. Three typical case histories are discussed.


RESULTS
Of 2112 patients in whom the primary diagnosis was not related to HSV keratitis, 18 presented with epithelial herpetic keratitis in their corneal graft. The incidence of newly acquired herpetic keratitis after penetrating keratoplasty was 1.2 per 1000 person-years. In most cases, the infection occurred in the first 2 years after the transplantation. Most often, well-known reactivating stimuli could have caused the HSV infection.


CONCLUSIONS
Herpes simplex virus keratitis may develop after penetrating keratoplasty even without a clinical history of HSV in the host. Thus, HSV should be considered in the differential diagnosis of a postpenetrating keratoplasty epithelial defect. The high incidence of this infection in the first 2 years after such surgery suggests a causal relation between corneal transplantation and the HSV infection.
Remeijer
L
L
Cornea and External Eye Disease Service, The Rotterdam Eye Hospital, The Netherlands.
Doornenbal
P
P
Geerards
A J
AJ
Rijneveld
W A
WA
Beekhuis
W H
WH
D000328:Adult; D000368:Aged; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000473:pathology / Q000821:virology*; D007635:Keratitis, Dendritic / Q000821:virology; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies