Laser in situ keratomileusis in patients with a history of ocular herpes.
OBJECTIVE
To report the outcomes of laser in situ keratomileusis (LASIK) in patients with a history of ocular herpes simplex virus (HSV) or herpes zoster ophthalmicus (HZO).


METHODS
Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain.


METHODS
In this retrospective case series, the records of eyes with a history of ocular herpes that had LASIK from 2003 through 2005 were reviewed. The main outcome measure was postoperative recurrence of ocular herpes.


RESULTS
Forty-nine eyes (48 patients) with a history of ocular herpes (HSV keratitis, 28 eyes; HSV eyelid lesions, 17 eyes; HZO, 4 eyes) were identified. All LASIK procedures were uneventful. Herpetic disease was inactive at the time of surgery in all eyes and for more than 1 year in 31 eyes. Perioperative antiviral systemic prophylaxis was used in 13 patients with a history of HSV keratitis. No eye developed reactivation of herpetic keratitis during the follow-up (range 1 to 28 months).


CONCLUSIONS
Laser in situ keratomileusis was safe in patients with a history of ocular herpes; no recurrences occurred during the follow-up period. However, candidates should be selected with caution and surgery performed only in eyes in which the herpes has been inactive for 1 year before surgery, without stromal disease, and with regular topography and pachymetry maps and normal corneal sensitivity. The most reasonable clinical strategy is perioperative systemic antiviral prophylaxis.
de Rojas Silva
Victoria
V
Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain. vderojas@terra.es
Rodríguez-Conde
Rosa
R
Cobo-Soriano
Rosario
R
Beltrán
Jaime
J
Llovet
Fernando
F
Baviera
Julio
J
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications*; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D016849:Keratitis, Herpetic / Q000150:complications*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D010865:Pilot Projects; D012008:Recurrence; D012030:Refractive Errors / Q000150:complications; D012189:Retrospective Studies; D018139:Simplexvirus / Q000502:physiology; D014775:Virus Activation / Q000187:drug effects
D000998:Antiviral Agents