title: Fulminant herpetic keratouveitis with flap necrosis following laser in situ keratomileusis: Case report and review of literature.
abstract: A 25-year-old woman presented with redness, pain, and diminution of vision that occurred 2 weeks after microkeratome-assisted laser in situ keratomileusis (LASIK). On presentation, corneal edema, Descemet membrane folds, keratic precipitates, stromal infiltrates, and flap necrosis were observed. Delayed post-LASIK microbial keratitis was diagnosed. The patient had no history of ocular herpes. Culture and scraping showed no organisms. Immunofluorescence stain was positive for the herpes simplex virus antigen. The patient was started on oral valacyclovir, and progress was monitored through serial clinical photographs and anterior segment optical coherence tomography. Resolution began within 3 days of initiating treatment and was complete in 4 weeks.
authors.affiliation: From the Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Arora
authors.affiliation: From the Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Electronic address: namrata.sharma@gmail.com.
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.affiliation: From the Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Supriya
authors.initials: S
authors.lastname: Arora
authors.affiliation: From the Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
mesh_terms: D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000284:Administration, Oral; D000328:Adult; D000956:Antigens, Viral / Q000276:immunology; D000998:Antiviral Agents / Q000627:therapeutic use; D003319:Corneal Stroma / Q000473:pathology* / Q000821:virology; D005260:Female; D006801:Humans; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ; D009216:Myopia / Q000601:surgery; D009336:Necrosis; D011183:Postoperative Complications; D018139:Simplexvirus / Q000276:immunology / Q000302:isolation & purification; D013524:Surgical Flaps / Q000473:pathology* / Q000821:virology; D041623:Tomography, Optical Coherence; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000956:Antigens, Viral; D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir