Huang S C, Wu W C, Tsai R J
Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1999 Sep;22(3):515-9.
The mechanism for herpetic keratitis reactivation remains unclear. When observed clinically, the reactivation may be associated with a variety of endogenous and exogenous stimuli, such as strong sunlight, fever, menstruation, and psychiatric disturbances. In experimental studies, most methods of inducing recurrence have involved some degree of corneal trauma, inflammation, neuronal stimulation, or damage to the nerves that innervate the cornea. Although corneal damage after laser iridectomy (LI) is well documented, recurrent herpetic keratitis induced by LI has never been reported. Here we present an unusual case of recurrent herpetic keratitis induced by LI. The location of the bullous keratopathy was strongly correlated to the site of laser iridectomy. Clinical findings as well as the dramatic response to antiviral treatment supported the diagnosis. Although the energy for laser iridectomy is relatively safe for most circumstances, the possibility of inducing herpetic keratitis cannot be ignored. Therefore it is important for clinicians to beware of this potential complication.
疱疹性角膜炎复发的机制尚不清楚。临床观察发现,复发可能与多种内源性和外源性刺激有关,如强光、发热、月经和精神障碍等。在实验研究中,大多数诱导复发的方法都涉及某种程度的角膜创伤、炎症、神经元刺激或支配角膜的神经损伤。虽然激光虹膜切除术(LI)后角膜损伤已有充分记录,但LI诱发复发性疱疹性角膜炎的情况从未被报道过。在此,我们报告一例由LI诱发的复发性疱疹性角膜炎的罕见病例。大疱性角膜病变的位置与激光虹膜切除术的部位密切相关。临床发现以及对抗病毒治疗的显著反应支持了这一诊断。尽管激光虹膜切除术的能量在大多数情况下相对安全,但诱发疱疹性角膜炎的可能性不能忽视。因此,临床医生必须警惕这种潜在的并发症。