上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

白内障术后初发性单纯疱疹病毒性角膜炎的诊疗观察

辜臻晟，陆上麟   

  1. 上海交通大学 医学院附属新华医院眼科， 上海 200092
  • 出版日期:2014-05-28 发布日期:2014-05-30
  • 作者简介:辜臻晟 （1968—）， 男， 主任医师， 博士， 硕士生导师; 电子信箱: poohgu@hotmail.com。

Observation on diagnosis and treatment of new-onset herpes simplex virus keratitis after cataract surgery

GU Zhen-sheng, LU Shang-lin   

  1. Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2014-05-28 Published:2014-05-30

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摘要：

目的 探讨白内障术后初发性单纯疱疹病毒性角膜炎（HSK）的临床表现和诊疗手段，为认识和预防该症提供借鉴。方法 回顾性分析2008—2012年7例白内障患者术后发生HSK的情况，追溯患者的病史和诊断治疗过程，分析发病的可能原因。结果 7例患者经抗病毒、滴用低浓度激素和人工泪液以及促进角膜上皮修复等治疗，1周内病情明显控制；2周后4例患者溃疡修复；其余患者3周后溃疡修复。除1例患者因角膜中央残留瘢痕混浊，视力受影响外，其余患者视力均恢复至发病前。结论 眼部手术创伤和局部使用可的松可诱发HSK的发生，早期因临床表现不典型易造成误诊，应引起重视。

关键词: 白内障手术, 单纯疱疹病毒, 角膜炎

Abstract:

Objective To investigate the clinical manifestations, diagnosis, and therapy of new-onset herpes simplex virus (HSV) keratitis after the cataract surgery and to provide references for identification and prophylaxis of this disease. Methods Seven cases with HSV keratitis after the cataract surgery from 2008 to 2012 were retrospectively analyzed. The history and process of diagnosis and treatment were traced and the possible reasons of this disease were analyzed. Results After being treated by the antivirus, low concentration steriods, artificial tears, and corneal epithelium repair agents, conditions of seven patients were much better within one week. Ulcers of four patients healed after two weeks and ulcers of other patients healed after three weeks. Only one patient's visual acuity was affected due to residual scar opacity at central region and all other patients' visual acuity reached the premorbid level. Conclusion Ocular surgical trauma followed by topically administrating corticosteriod can induce the occurrence of HSV keratitis. Since its initial clinical representations are not typical, misdiagnosis can be made.

Key words: cataract surgery, herpes simplex virus, keratitis