New onset of herpes simplex virus epithelial keratitis after penetrating keratoplasty.
OBJECTIVE
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).


METHODS
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.
Rezende
Renata A
RA
Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. ecohen@willseye.org
Uchoa
Uchoandro B C
UB
Raber
Irving M
IM
Rapuano
Christopher J
CJ
Laibson
Peter R
PR
Cohen
Elisabeth J
EJ
D000212:Acyclovir / Q000627:therapeutic use; D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003316:Corneal Diseases / Q000601:surgery; D004847:Epithelial Cells / Q000473:pathology / Q000821:virology; D019573:Epithelium, Corneal / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D007635:Keratitis, Dendritic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014271:Trifluridine / Q000627:therapeutic use
D000998:Antiviral Agents; D014271:Trifluridine; D000212:Acyclovir