Cataract surgery in herpes simplex virus ocular disease

Area of Science:

• Ophthalmology
• Virology
• Surgical Outcomes

Background:

• Herpes simplex virus (HSV) can cause anterior segment ocular disease, potentially affecting visual outcomes.
• Cataract surgery in these compromised eyes presents unique challenges and risks.

Purpose of the Study:

• To evaluate the visual results and complications of cataract surgery in patients with a history of HSV-related anterior segment ocular disease.
• To identify factors associated with postoperative outcomes and inflammation recurrence.

Main Methods:

• A retrospective observational cohort study was conducted.
• Clinical records of 37 patients who underwent cataract surgery in eyes with HSV keratitis and/or anterior uveitis were reviewed.
• Outcomes assessed included visual acuity, intraoperative and postoperative complications, and recurrence of ocular inflammation.

Main Results:

• Vision improved in 83.9% of eyes, with 70.0% achieving corrected distance visual acuity >20/50 at 3 months.
• Postoperative inflammation recurred in 45.9% of patients, with 22.5% experiencing recurrence within the first year.
• Intraoperative complications were rare (2.7%), but postoperative endophthalmitis (2.7%) and cystoid macular edema (2.7%) occurred. Prior recurrence history and iris defects increased recurrence risk.

Conclusions:

• Cataract surgery can offer visual improvement for most eyes with prior HSV disease.
• However, the prognosis is guarded, particularly in eyes with corneal scarring, due to a significant risk of recurrent inflammation.
• Ensuring a period of ocular quiescence before surgery is advisable to minimize complications.