Ocular surgery after herpes simplex and herpes zoster keratitis. 2020

Piotr Kanclerz, and Jorge L Alio
Hygeia Clinic, Gdańsk, Poland.

OBJECTIVE 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.

UI MeSH Term Description Entries
D006563 Herpes Zoster Ophthalmicus Virus infection of the Gasserian ganglion and its nerve branches characterized by pain and vesicular eruptions with much swelling. Ocular involvement is usually heralded by a vesicle on the tip of the nose. This area is innervated by the nasociliary nerve. Herpes Zoster, Ocular,Ocular Herpes Zoster
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000998 Antiviral Agents Agents used in the prophylaxis or therapy of VIRUS DISEASES. Some of the ways they may act include preventing viral replication by inhibiting viral DNA polymerase; binding to specific cell-surface receptors and inhibiting viral penetration or uncoating; inhibiting viral protein synthesis; or blocking late stages of virus assembly. Antiviral,Antiviral Agent,Antiviral Drug,Antivirals,Antiviral Drugs,Agent, Antiviral,Agents, Antiviral,Drug, Antiviral,Drugs, Antiviral
D015948 Keratoplasty, Penetrating Partial or total replacement of all layers of a central portion of the cornea. Keratoplasties, Penetrating,Penetrating Keratoplasties,Penetrating Keratoplasty
D016039 Corneal Transplantation Partial or total replacement of the CORNEA from one human or animal to another. Grafting, Corneal,Keratoplasty,Keratoplasty, Lamellar,Transplantation, Corneal,Cornea Transplantation,Transplantation, Cornea,Cornea Transplantations,Corneal Grafting,Corneal Graftings,Corneal Transplantations,Graftings, Corneal,Keratoplasties,Keratoplasties, Lamellar,Lamellar Keratoplasties,Lamellar Keratoplasty,Transplantations, Cornea,Transplantations, Corneal
D016849 Keratitis, Herpetic A superficial, epithelial Herpesvirus hominis infection of the cornea, characterized by the presence of small vesicles which may break down and coalesce to form dendritic ulcers (KERATITIS, DENDRITIC). (Dictionary of Visual Science, 3d ed) Herpes Simplex Keratitis,Herpes Simplex, Ocular,Ocular Herpes Simplex,Herpes Simplex Keratitides,Herpetic Keratitides,Herpetic Keratitis,Keratitides, Herpes Simplex,Keratitides, Herpetic,Keratitis, Herpes Simplex

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