1/6. Polymicrobial keratitis after laser in situ keratomileusis.PURPOSE: To report a case of polymicrobial infectious keratitis in one eye of a patient who had undergone bilateral simultaneous laser in situ keratomileusis (LASIK). methods: A 21-year-old healthy female developed infectious keratitis in her right eye after bilateral LASIK surgery. Material obtained from the infective foci was sent for bacterial and fungal cultures and herpes simplex virus antigen detection, and broad spectrum antimicrobial therapy was instituted. RESULTS: staphylococcus epidermidis and fusarium solani were detected on culture and herpes simplex virus antigen was found to be positive. The patient did not respond to medical therapy and subsequently the ulcer perforated. A therapeutic keratoplasty was performed and the final best-corrected visual acuity was 20/40, 1 month after keratoplasty. CONCLUSION: Polymicrobial infectious keratitis, although rare, is a potential sight-threatening complication of LASIK.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/6. Atypical herpes simplex keratitis (HSK) presenting as a perforated corneal ulcer with a large infiltrate in a contact lens wearer: multinucleated giant cells in the Giemsa smear offered a clue to the diagnosis.PURPOSE: To report a case of atypical herpes simplex keratitis initially diagnosed as bacterial keratitis, in a contact lens wearer. RESULTS: Case report of an 18-year-old woman using contact lenses who presented with pain, redness and gradual decrease in vision in the right eye. Examination revealed a paracentral large stromal infiltrate with a central 2-mm perforation. Corneal and conjunctival scrapings were collected for microbiological investigations. Corneal tissue was obtained following penetrating keratoplasty. Corneal scraping revealed no microorganisms. Giemsa stained smear showed multinucleated giant cells. Conjunctival, corneal scrapings and tissue were positive for herpes simplex virus - 1 (HSV) antigen. Corneal tissue was positive for HSV dna by PCR. CONCLUSIONS: Atypical HSV keratitis can occur in contact lens wearers. A simple investigation like Giemsa stain may offer a clue to the diagnosis.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
3/6. culture-proven herpetic keratitis after penetrating keratoplasty in patients with no previous history of herpes disease.OBJECTIVE: To report three cases of herpetic infection in recipients of organ-cultured donor corneas among 586 consecutive corneal transplantation procedures. methods: Three patients with no history of symptomatic herpes infection underwent corneal transplantation for keratoconus (2 patients) and Fuchs dystrophy (1 patient). Two patients developed keratouveitis and primary graft failure. The third patient developed dendritic keratitis in the graft. culture of corneal scrapings and the patient's bandage contact lens were positive for herpes simplex virus type 1 (HSV-1). Donor and recipient sera were tested for HSV serology by EIA. Recipient corneal buttons were studied by means of transmission electron microscopy and immunohistochemistry. The three HSV-1 strains were genotyped by sequencing part of a variable antigenic domain of glycoprotein B (gB). RESULTS: None of the donor corneas showed endothelial cell necrosis after organ culture. All keratoplasties performed with the three mate donor corneas had an uncomplicated course. All three donor sera were positive for HSV. Preoperative recipient sera were positive for HSV. Analysis of the recipient corneal buttons showed no evidence of herpetic infection. sequence analysis revealed three different gB genotypes. CONCLUSION: Ascertaining that a postoperative herpetic infection in a corneal transplant originates from the donor tissue is still difficult. Although some features of the reported cases suggest donor-to-host transmission of herpes simplex virus, the recipients could have been the source of the virus.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
4/6. Bilateral herpes simplex virus type 2 keratitis: a clinicopathologic report with immunohistochemical and ultrastructural observations.This report describes the clinical, histopathologic, ultrastructural, and immunohistochemical findings in two corneal buttons from a 13-year-old girl who developed bilateral progressive corneal stromal opacification during childhood. As determined by light microscopy, both corneal buttons were edematous with a chronic inflammatory infiltrate confined to the deep layers of the stroma. We detected intranuclear eosinophilic inclusions in some epithelial cells. We detected herpesvirus particles in stromal keratocytes and endothelial cells by transmission electron microscopy. immunohistochemistry studies identified concurrent expression of specific herpes simplex virus type 2 antigen in corneal epithelial cells, in keratocytes in the deep layers of the stroma, and in endothelial cells. The cause of progressive bilateral stromal corneal opacification in this child was herpes simplex virus type 2 keratitis. This condition should be considered in the differential diagnosis of progressive, bilateral corneal opacification in children.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
5/6. infection of the corneal endothelium in herpes simplex keratitis.PURPOSE: To describe viral infection of the corneal endothelium in a patient with recurrent herpes simplex virus keratitis in the corneal graft. methods: Case report. A healthy 28-year-old man presented with necrotizing stromal keratitis and corneal perforation in the corneal graft. A second penetrating keratoplasty was performed. The corneal button was processed for histopathologic, immunohistochemical, and electron microscopic studies. RESULTS: Histopathologically, the corneal endothelium showed viral inclusion bodies. herpes simplex virus antigens and viral particles were identified in stromal keratocytes and corneal endothelial cells. CONCLUSION: Productive herpes simplex virus infection of the corneal endothelial cells may contribute to corneal graft failure in recurrent herpes simplex virus infections.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
6/6. Recurrent subepithelial corneal opacities after excimer laser phototherapeutic keratectomy.PURPOSE: To report the recurrence of presumed post-viral conjunctivitis subepithelial corneal opacities after excimer laser phototherapeutic keratectomy (PTK). METHOD: Case report. RESULTS: A 33-year-old ophthalmic technician developed recurrence of opacities after treatment of presumed post-viral keratitis subepithelial corneal opacities with the excimer laser. CONCLUSIONS: Post-viral keratitis subepithelial corneal opacities may recur after removal by excimer laser PTK. recurrence of these opacities in anterior corneal stroma previously unaffected by opacities before laser treatment suggests the presence of viral antigen in deeper corneal tissue than that occupied by the original subepithelial opacities. The recurrence also suggests likely routes of corneal antibody penetration in the formation of these opacities. Intensive topical steroid treatment may play a role by increasing the depth of viral particle penetration into corneal stroma.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |