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Ocular surgery after herpes simplex and herpes zoster keratitis

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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.

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Data availability

Search strategy included as “Appendix.”

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Funding

This study has been supported in part by the Red Temática de Investigación Cooperativa en Salud (RETICS), reference number RD16/0008/0012, financed by the Instituto Carlos III – General Subdirection of Networks and Cooperative Investigation Centers (R&D&I National Plan 2008-2011), and the European Regional Development Fund (Fondo Europeo de Desarrollo Regional FEDER).

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Author notes

  1. Piotr Kanclerz and Jorge L. Alio have contributed equally to this work.

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  1. Hygeia Clinic, Gdańsk, Poland

    Piotr Kanclerz

  2. Vissum Instituto Oftalmologico de Alicante, Vissum Corporation, Avda de Denia S/N, 03015, Alicante, Spain

    Jorge L. Alio

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Appendix: Search strategy

Appendix: Search strategy

Literature searches of the PubMed and Web of Science databases were conducted on December 31, 2019; the search strategies are as follows. Specific limited update searches were conducted after December 31, 2019.

PubMed search (publication date 1/1/1900–12/31/2019)

((“herpes”[Title]) OR (“herpetic keratitis”[Title)) AND ((“cataract surgery”[Title]) OR (“cataract extraction”[Title]) OR (“phacoemulsification”[Title]) OR (“keratoplasty”[Title]) OR (“corneal refractive surgery”[Title]) OR (“laser in situ keratomileusis”[Title]) OR (“LASIK”[Title]) OR (“laser epithelial keratomileusis”[Title]) OR (“LASEK”[Title]) OR (“photorefractive keratectomy”[Title]) OR (“PRK”[Title]) OR (“small incision lenticule extraction”[Title]) OR (“SMILE”[Title])). 108 references.

Web of Science search (publication date 1/1/1900–12/31/2019)

(TI = (herpes) OR TI = (herpetic keratitis)) AND (TI = (cataract surgery) OR TI = (cataract extraction) OR TI = (phacoemulsification) OR TI = (keratoplasty) OR TI = (corneal refractive surgery) OR TI = (laser in situ keratomileusis) OR TI = (LASIK) OR TI = (laser epithelial keratomileusis) OR TI = (LASEK) OR TI = (photorefractive keratectomy) OR TI = (PRK) OR TI = (small incision lenticule extraction) OR TI = (SMILE)) Indexes = SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, BKCI-S, BKCI-SSH, ESCI, CCR-EXPANDED, IC Timespan = All years. 112 references.

After removing duplicated 146 publications were analyzed.

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Kanclerz, P., Alio, J.L. Ocular surgery after herpes simplex and herpes zoster keratitis. Int Ophthalmol 40, 3599–3612 (2020). https://doi.org/10.1007/s10792-020-01539-6

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