Alsharif Heba M, Alruwaili Rahaf M, Alsaleh Ahmed
Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, SAU.
Cureus. 2025 Jun 29;17(6):e86985. doi: 10.7759/cureus.86985. eCollection 2025 Jun.
We report a case of atypical new-onset herpetic necrotizing sclerokeratitis after implantable collamer lens surgery. A 37-year-old healthy Saudi female, known to have keratoconus underwent keratoplasty 14 years ago, followed by implantable collamer lens surgery (ICL) for visual rehabilitation nine months ago in the left eye. She presented to our institute with a history of subacute painful ocular pain and redness in her left eye over seven months. Upon assessment, the left eye's visual acuity was 20/200. Examination of the anterior segment showed injected conjunctiva, episcleral and scleral blood vessels, scleral thinning associated with peripheral keratitis, keratic precipitates, and decreased corneal sensation. Diagnostic ultrasonography (B-scan) revealed mild vitreous opacities with a normal optic nerve head and no retinal choroidal thickening. The results of the right eye examination were unremarkable. The patient was found to have atypical herpetic necrotizing sclerokeratitis and was treated with topical and oral antivirals for three months, with significant improvement. Thus, timely detection and treatment were crucial for minimizing vision-threatening complications.
我们报告一例可植入角膜胶原晶状体手术后出现的非典型新发疱疹性坏死性巩膜角膜炎病例。一名37岁健康的沙特女性，14年前已知患有圆锥角膜并接受了角膜移植手术，九个月前因视力康复在左眼进行了可植入角膜胶原晶状体手术（ICL）。她因左眼七个多月来出现亚急性疼痛性眼痛和眼红的病史前来我院就诊。评估时，左眼视力为20/200。眼前节检查显示结膜充血、巩膜和巩膜血管充血、巩膜变薄伴周边角膜炎、角膜后沉着物以及角膜感觉减退。诊断性超声检查（B超）显示轻度玻璃体混浊，视神经乳头正常，视网膜脉络膜无增厚。右眼检查结果无异常。该患者被诊断为非典型疱疹性坏死性巩膜角膜炎，并接受了局部和口服抗病毒药物治疗三个月，病情有显著改善。因此，及时检测和治疗对于将威胁视力的并发症降至最低至关重要。
