Ocular surgery after herpes simplex and herpes zoster keratitis
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REVIEW
Ocular surgery after herpes simplex and herpes zoster keratitis Piotr Kanclerz . Jorge L. Alio
Received: 24 April 2020 / Accepted: 25 July 2020 Ó Springer Nature B.V. 2020
Abstract Purpose The recurrence of herpetic stromal keratitis (HSK) and herpes zoster ophthalmicus (HZO) has been reported after a variety of ocular surgeries. The aim of this study was to review the evidence on the preventive methods employed in the perioperative period in patients having undergone HSK/HZO. Methods The PubMed and Web of Science databases were the main resources used to conduct the medical literature search. An extensive search was performed to identify relevant articles concerning the prophylaxis against and risk of HSK/HZO recurrence in patients undergoing ocular surgery up to December 31, 2019. Results The disturbance of the corneal nerve plexus occurs during several ocular surgeries including penetrating keratoplasty, lamellar keratoplasty, corneal cross-linking, cataract surgery, as well as photorefractive and phototherapeutic procedures. Such trauma, as well as modulation of the ocular immunological response caused by steroids applied
postoperatively, might engender the HSK/HZO reactivation which is not uncommon. There is strong evidence that oral prophylaxis should be recommended just after surgery in patients undergoing penetrating keratoplasty and having suffered from HSK/HZO. For other types of surgeries, the evidence is less compelling; nevertheless, a period of disease quiescence and oral prophylaxis should still be considered. Conclusions Within the article, we discuss the available evidence for HSK/HZO prophylaxis in ocular surgery. Additional studies would be required to define the real risk of HSK/HZO recurrence following eye surgeries, and particularly cataract surgery, and to confirm the utility of perioperative HSK/HZO prophylaxis. Keywords Cataract surgery Herpetic stromal keratitis Herpes zoster ophthalmicus Keratoplasty LASIK Refractive surgery
Piotr Kanclerz and Jorge L. Alio have contributed equally to this work.
Introduction
P. Kanclerz Hygeia Clinic, Gdan´sk, Poland
Background of herpetic keratitis and its related comorbidities
J. L. Alio (&) Vissum Instituto Oftalmologico de Alicante, Vissum Corporation, Avda de Denia S/N, 03015 Alicante, Spain e-mail: [email protected]
The prevalence rates of herpes simplex virus (HSV) types 1 and 2 increase with age and are estimated to
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Int Ophthalmol
reach up to 90% in adult populations in Africa and the Americas and up to 40% in Europe [1]. However, only 20–30% of herpes-inoculated patients develop clinical manifestations, most commonly herpes labialis [2]. Ocular HSV infection can manifest during the first exposure to the virus (primary infections) or, more commonly, as an engagement of a new anatomical location (the eye) in an individual with a latent HSV infection [3]. Primary HSV eye infections are infrequent, as they require direct contact between the ocular mucous membranes and t
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