Remeijer L, Doornenbal P, Geerards A J, Rijneveld W A, Beekhuis W H
Cornea and External Eye Disease Service, The Rotterdam Eye Hospital, The Netherlands.
Ophthalmology. 1997 Apr;104(4):648-52. doi: 10.1016/s0161-6420(97)30257-7.
After penetrating keratoplasty for reasons unrelated to herpes simplex virus (HSV) keratitis, any nonspecific epithelial defect may still be caused by HSV. The purpose of this study is to determine the incidence of newly acquired herpetic keratitis and to assess contributing factors.
The authors retrospectively studied the results of 2398 penetrating keratoplasties performed between 1980 and 1995. Three typical case histories are discussed.
Of 2112 patients in whom the primary diagnosis was not related to HSV keratitis, 18 presented with epithelial herpetic keratitis in their corneal graft. The incidence of newly acquired herpetic keratitis after penetrating keratoplasty was 1.2 per 1000 person-years. In most cases, the infection occurred in the first 2 years after the transplantation. Most often, well-known reactivating stimuli could have caused the HSV infection.
Herpes simplex virus keratitis may develop after penetrating keratoplasty even without a clinical history of HSV in the host. Thus, HSV should be considered in the differential diagnosis of a postpenetrating keratoplasty epithelial defect. The high incidence of this infection in the first 2 years after such surgery suggests a causal relation between corneal transplantation and the HSV infection.
在因与单纯疱疹病毒（HSV）角膜炎无关的原因进行穿透性角膜移植术后，任何非特异性上皮缺损仍可能由HSV引起。本研究的目的是确定新获得性疱疹性角膜炎的发病率并评估相关因素。
作者回顾性研究了1980年至1995年间进行的2398例穿透性角膜移植术的结果。讨论了三个典型病例史。
在2112例原发性诊断与HSV角膜炎无关的患者中，有18例在其角膜移植片中出现上皮性疱疹性角膜炎。穿透性角膜移植术后新获得性疱疹性角膜炎的发病率为每1000人年1.2例。在大多数情况下，感染发生在移植后的头2年。最常见的是，众所周知的激活刺激可能导致了HSV感染。
即使宿主没有HSV的临床病史，穿透性角膜移植术后也可能发生单纯疱疹病毒性角膜炎。因此，在穿透性角膜移植术后上皮缺损的鉴别诊断中应考虑HSV。这种感染在术后头2年的高发病率表明角膜移植与HSV感染之间存在因果关系。
