From the Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand (Al-Ani, Lu, Meyer, Niederer); Department of Ophthalmology, University of Auckland, Auckland, New Zealand (Al-Ani, Meyer, Niederer).
J Cataract Refract Surg. 2022 Mar 1;48(3):304-309. doi: 10.1097/j.jcrs.0000000000000745.
To investigate the outcomes and complications associated with cataract surgery in eyes with herpes simplex virus (HSV)-related anterior segment ocular disease.
Public tertiary center in Auckland, New Zealand.
Retrospective observational cohort study.
Clinical records of patients diagnosed with HSV-related keratitis and/or anterior uveitis who underwent subsequent cataract surgery in the affected eye were reviewed. Main outcomes measured were visual outcome, complications, and recurrence.
37 eyes of 37 patients were included. Intraoperative complications occurred in 1 patient (2.7%) with iris prolapse. Keratitis or uveitis recurred postoperatively in 17 patients (45.9%) 8 patients (22.5%); 22.5% experienced recurrences in the first year postoperatively. 1 case (2.7%) of postoperative cystoid macular edema and 1 (2.7%) postoperative endophthalmitis occurred. Corrected distance visual acuity at 3 months was >20/50 in 21 patients (70.0%), 20/50 to 20/200 in 4 patients (12.9%), and ≤20/200 in 6 patients (19.4%). Vision improved in 26 eyes (83.9%) and worsened in only 1 eye (3.2%). Risk for recurrent inflammation was associated with a greater number of recurrences prior to surgery (hazard rate [HR] 1.31), time quiescent prior to surgery (HR 0.48), and iris transillumination defect at preoperative assessment (HR 57.66).
Cataract surgery in eyes with previous HSV disease may improve visual acuity for most of the eyes but, overall, carries a guarded prognosis, particularly in eyes with corneal scarring. There is a significant risk for recurrent inflammation in the first year postoperatively. If possible, surgeons should ensure a period of disease quiescence prior to surgery.
研究与单纯疱疹病毒（HSV）相关前节眼部疾病相关的白内障手术的结果和并发症。
新西兰奥克兰的一家公立三级中心。
回顾性观察性队列研究。
回顾性分析诊断为 HSV 相关性角膜炎和/或前葡萄膜炎且随后在受影响眼行白内障手术的患者的临床记录。主要测量的结果是视力结果、并发症和复发。
纳入 37 例患者的 37 只眼。术中并发症发生在 1 例（2.7%）患者中，表现为虹膜脱出。17 例（45.9%）患者术后出现角膜炎或葡萄膜炎复发，其中 8 例（22.5%）在术后 1 年内复发。1 例（2.7%）发生术后黄斑囊样水肿，1 例（2.7%）发生术后眼内炎。3 个月时的矫正视力>20/50 者 21 例（70.0%），20/50 至 20/200 者 4 例（12.9%），≤20/200 者 6 例（19.4%）。26 只眼（83.9%）视力改善，仅 1 只眼（3.2%）视力恶化。炎症复发的风险与术前复发次数较多（危险比[HR]1.31）、术前静止时间较长（HR 0.48）和术前虹膜透光缺陷（HR 57.66）相关。
对于先前有 HSV 疾病的眼睛，白内障手术可能会提高大多数眼睛的视力，但总体预后较差，尤其是在有角膜瘢痕的眼睛。术后 1 年内有明显的炎症复发风险。如果可能的话，外科医生应确保在手术前有一段疾病静止期。
