Surgical management of herpes simplex keratitis

The various surgical managements of herpes simplex keratitis are listed. Our management is "atraumatic" keratoplasty, if vision is reduced, if the disease is protracted, or if perforation occurs. Our preoperative care is aimed at the production of a quiet eye with no active virus infection, by the use of antiviral drops, steroids, antibiotics, and bandage contact lenses. Removal of all corneal disease is desirable, but not mandatory. Perforations are managed in the same manner, but the host window is started at the perforation. Postoperative management is characterized by the use of therapeutic modalities necessary to prevent or treat complications, including steroids and frequent observation to check for complications of treatment. Our understanding of herpes simplex virus infections as they relate to surgical management is presented. The results of treatment warrant continuation of our efforts--but lead to the conclusion that it would be most helpful if latent virus infection could be eradicated.