Reactivated herpetic keratitis following laser in situ keratomileusis.
A 40-year-old woman presented with an unusual form of corneal herpetic reactivation 5 weeks after laser in situ keratomileusis. The cornea showed diffuse edema and a stromal ring infiltrate (disciform in appearance). Oral antiviral and topical steroids in tapered dosages were administered. The infiltrate disappeared within 6 weeks. Progressive improvement was also seen in all the parameters on Pentacam scans, including the pachymetry, keratometry readings, and elevation on the anterior float. Herpetic reactivation may occur in many forms after excimer laser ablation. Timely diagnosis and management is crucial to maintain good structural and visual outcomes. Pentacam analysis may serve as a useful adjunct in following the progression of herpetic reactivation cases.
Jain
Vandana
V
Department of Cornea, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA.
Pineda
Roberto
R
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001251:Astigmatism / Q000601:surgery; D003315:Cornea / Q000821:virology; D019781:Corneal Topography; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D018259:Herpesvirus 1, Human / Q000502:physiology*; D006801:Humans; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer / Q000627:therapeutic use; D009216:Myopia / Q000601:surgery; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D014775:Virus Activation; D014792:Visual Acuity
D000998:Antiviral Agents; D005938:Glucocorticoids; C009935:prednisolone acetate; D011239:Prednisolone; D000212:Acyclovir