title: Herpetic Keratitis after Corneal Collagen Cross-Linking with Riboflavin and Ultraviolet-A for Keratoconus.
abstract: To describe two cases of herpetic keratitis after corneal collagen cross-linking (CXL) for progressive keratoconus. An 18-year-old male and a 21-year-old male with rapidly progressive keratoconus were treated with CXL. Postoperatively, on the 6(th) and 9(th) days respectively, a dendritic ulcer was observed in the treated eye. The corneal sensation was significantly diminished compared to the fellow eye. Both patients had no prior history of herpetic eye disease or cold sores. The keratitis improved dramatically over the following days after initiation of antiviral therapy. At 4 months, the visual acuity was stable without corneal scarring. Herpetic keratitis could be induced by CXL even in patients with no history of previous herpetic eye disease. Early diagnosis and proper treatment can facilitate the successful management of this rare but important complication.
authors.affiliation: Department of Ophthalmology, Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, P. O. Box 7191, Riyadh 11462, Saudi Arabia.
authors.forename: Awad
authors.initials: A
authors.lastname: Al-Qarni
authors.affiliation: Department of Ophthalmology, Cornea and Anterior Segment Division, King Khaled Eye Specialist Hospital, P. O. Box 7191, Riyadh 11462, Saudi Arabia.
authors.forename: Mosa
authors.initials: M
authors.lastname: AlHarbi
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D003094:Collagen / Q000378:metabolism*; D003319:Corneal Stroma / Q000378:metabolism; D003432:Cross-Linking Reagents; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011183:Postoperative Complications; D012256:Riboflavin / Q000627:therapeutic use*; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D015774:Ganciclovir; D012256:Riboflavin
keywords: Cross-linking; Cross-linking Complication; Herpetic Keratitis; Keratoconus