A Retrospective Study of Herpetic Keratitis in Patients with Keratoconus after Crosslinking Surgery

The aim of this study was to perform a retrospective analysis of patients who underwent cross-linking for keratoconus, in the Department of Ophthalmology of the Medical University of Silesia in Katowice, between 2011 and 2020, regarding the occurrence of herpetic keratitis after the procedure.

We analyzed the medical history of 543 patients who underwent cross-linking surgery.

In the analyzed group, there were nine cases of herpetic keratitis (six men and three women), aged from 16 to 40 years (mean 26.2 years). The mean follow-up period was 49.3 months (16-82 months). The average time from surgery to the manifestation of the first symptoms of keratitis was 4.3 days (2-6 days). In two cases, iritis was observed, and in one of them, iritis was the first symptom. After systemic and topical administration of acyclovir, ulceration healed in all patients. Corneal healing time ranged from 10 days to 3 weeks (average 13.7 days). In one patient, a recurrence of the inflammation was observed after 8 months.

Patients should be carefully observed in the early post-CXL period. Herpetic keratitis could be induced by CXL even in patients with no history of herpetic disease.