NEWLY ACQUIRED HERPES-SIMPLEX VIRUS KERATITIS AFTER PENETRATING KERATOPLASTY

Background: After penetrating keratoplasty for reasons unrelated to he rpes simplex virus (HSV) keratitis, any nonspecific epithelial defect may still be caused by HSV. The purpose of this study is to determine the incidence of newly acquired herpetic keratitis and to assess contr ibuting factors. Methods: The authors retrospectively studied the resu lts of 2398 penetrating keratoplasties performed between 1980 and 1995 . Three typical case histories are discussed. Results: Of 2112 patient s in whom the primary diagnosis was not related to HSV keratitis, 18 p resented with epithelial herpetic keratitis in their corneal graft. Th e incidence of newly acquired herpetic keratitis after penetrating ker atoplasty was 1.2 per 1000 person-years. In most cases, the infection occurred in the first 2 years after the transplantation. Most often, w ell-known reactivating stimuli could have caused the HSV infection. Co nclusions: Herpes simplex virus keratitis may develop after penetratin g keratoplasty even without a clinical history of HSV in the host. Thu s, HSV should be considered in the differential diagnosis of a postpen etrating keratoplasty epithelial defect. The high incidence of this in fection in the first 2 years after such surgery suggests a causal rela tion between corneal transplantation and the HSV infection.