Vrabec M P, Anderson J A, Rock M E, Binder P S, Steinert R F, Durrie D S, Chase D S
Department of Ophthalmology, University of Vermont College of Medicine, Burlington.
CLAO J. 1994 Jan;20(1):41-4.
Excimer laser phototherapeutic keratectomy is emerging as an alternative therapy to corneal transplantation for the treatment of multiple corneal diseases. We report three cases of recurrence of herpes simplex keratitis after treatment of herpetic corneal scars with the excimer laser. In two cases, the patients underwent subsequent corneal transplantation. One corneal button examined with transmission electron microscopy (TEM) demonstrated a well-differentiated epithelium over the area of ablation, a linear, continuous basal lamina, and no viral particles. Anterior stromal scarring may have resulted from the laser treatment itself or may represent incomplete ablation of previous scars. Whether reactivation of the virus was stimulated by the laser or occurred as part of the natural history of the disease is uncertain. We recommend that patients who undergo excimer laser treatment for herpes simplex scarring receive careful follow-up including antiviral coverage.
准分子激光角膜切削术正逐渐成为治疗多种角膜疾病的角膜移植替代疗法。我们报告了3例单纯疱疹性角膜炎患者在用准分子激光治疗疱疹性角膜瘢痕后复发的病例。其中2例患者随后接受了角膜移植。用透射电子显微镜（TEM）检查的一个角膜植片显示，消融区域上皮分化良好，基底膜呈线性、连续，且未见病毒颗粒。前部基质瘢痕可能是激光治疗本身所致，也可能代表先前瘢痕的不完全消融。病毒再激活是由激光刺激引起还是作为疾病自然病程的一部分尚不确定。我们建议，接受准分子激光治疗单纯疱疹性瘢痕的患者应接受仔细随访，包括抗病毒治疗。
