Department of Ophthalmology, University of Florida, Gainesville, Florida, USA.
Curr Opin Ophthalmol. 2018 Jul;29(4):347-354. doi: 10.1097/ICU.0000000000000484.
The purpose of this review is to discuss the options for, and recent developments in, the surgical treatment of herpes keratitis. Although the mainstay of treatment of herpetic keratitis is topical or oral antiviral agents, surgical intervention may be necessary for corneal melting or long-term complications such as scarring, lipid keratopathy, necrotizing keratitis, and neurotrophic keratitis.
There are a number of surgical therapies available for herpes keratitis. Preferred therapeutic modalities differ based on the size, causation, and location of the infection but consist of either replacement of the infected tissue or structural support of the tissue to allow healing. Incremental improvements in the existing treatment modalities have made them more effective, easier, and safer, whereas novel therapies such as corneal neurotization are starting to be described in ophthalmic literature.
Several options are available for surgically managing the complications of herpes keratitis. Ophthalmologists should select the optimal procedure based on the individual patient's situation. VIDEO ABSTRACT: http://links.lww.com/COOP/A28.
本文旨在讨论治疗疱疹性角膜炎的手术选择和最新进展。虽然疱疹性角膜炎的主要治疗方法是局部或口服抗病毒药物，但对于角膜融解或长期并发症（如瘢痕、脂质性角膜炎、坏死性角膜炎和神经营养性角膜炎），手术干预可能是必要的。
有多种手术疗法可用于治疗疱疹性角膜炎。首选的治疗方式取决于感染的大小、病因和位置，但包括替换受感染的组织或对组织进行结构性支撑，以促进愈合。现有治疗方式的不断改进使其更有效、更容易且更安全，而角膜神经化等新疗法也开始在眼科文献中得到描述。
有多种手术选择可用于治疗疱疹性角膜炎的并发症。眼科医生应根据患者的具体情况选择最佳的手术方案。
