title: Conjunctival flap covering combined with antiviral and steroid therapy for severe herpes simplex virus necrotizing stromal keratitis.
abstract: Herpes simplex virus (HSV) necrotizing stromal keratitis is a common type of herpetic stromal keratitis (HSK). Antiviral medication alone cannot control the disease, and corticosteroid eye drops may aggravate the ulcer and result in corneal perforation. Amniotic membrane transplantation effectively treats superficial corneal ulcer resulting from necrotizing stromal HSK. However, the efficacy of this approach seems to be limited for more serious cases. This study presented the clinical treatment of severe HSV necrotizing stromal keratitis (ulcer depth greater than half of the corneal stroma) by conjunctival flap covering surgery in 25 patients (25 eyes) combined with antivirus and corticosteroid treatment at Shandong Eye Hospital from January 2007 to December 2013. Clinical results showed that the mean best spectacle-corrected visual acuity improved from preoperative 20/333 to postoperative 20/40 (P < 0.05). All patients recovered ocular surface stabilization. There was recurrence in two eyes, which was cured with antiviral medication. Conjunctival flap covering combined with antivirus and corticosteroid treatment is effective in treating severe HSV necrotizing stromal keratitis.
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China ; Bascom Palmer Eye Institute, University of Miami, 1638 NW 10th Avenue, Miami, FL, USA.
authors.forename: Hua
authors.identifier: 0000-0002-1326-6946
authors.initials: H
authors.lastname: Gao
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
authors.forename: Yanni
authors.initials: Y
authors.lastname: Jia
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
authors.forename: Suxia
authors.initials: S
authors.lastname: Li
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Wang
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, 1638 NW 10th Avenue, Miami, FL, USA.
authors.forename: Yaohong
authors.initials: Y
authors.lastname: Tan
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan 250021, China.
authors.forename: Weiyun
authors.initials: W
authors.lastname: Shi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000601:surgery*; D003319:Corneal Stroma / Q000473:pathology; D003320:Corneal Ulcer / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016849:Keratitis, Herpetic / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D012008:Recurrence; D013524:Surgical Flaps; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents