J Korean Ophthalmol Soc > Volume 60(1); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(1):75-79.
DOI: https://doi.org/10.3341/jkos.2019.60.1.75    Published online January 15, 2019.
A Case of Herpes Simplex Keratitis after Descemet Membrane Endothelial Keratoplasty.
Yousook Hwang, Yang Kyung Cho
Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea. yangkyeung@hanmail.net
데스메막내피각막이식술 후 발병한 단순포진바이러스각막염 1예
황유숙⋅조양경
가톨릭대학교 의과대학 안과 및 시과학교실
Correspondence:  Yang Kyung Cho,
Email: yangkyeung@hanmail.net
Received: 31 May 2018   • Revised: 26 July 2018   • Accepted: 28 December 2018
Abstract
PURPOSE
We report a case of herpes simplex keratitis after Descemet membrane endothelial keratoplasty (DMEK). CASE SUMMARY: A 67-year-old male underwent DMEK in his left eye due to pseudophakic bullous keratopathy. One week after DMEK, re-bubbling was performed due to partial detachment of Descemet's membrane at the corneal periphery. After re-bubbling, the cornea remained clear and the patient's visual acuity gradually improved. Two months after DMEK, the patient presented with mild discomfort and decreased visual acuity. The cornea showed an irregular, narrow dendrite with an epithelial defect and surrounding opacity. After confirming that Descemet's membrane was attached, the patient was started on oral valacyclovir for suspected herpes keratitis. Herpes simplex virus type 1 was eventually identified by polymerase chain reaction. The corneal lesion resolved after three weeks of antiviral treatment. CONCLUSIONS: Similar to penetrating keratoplasty, DMEK can trigger outbreaks of herpes simplex keratitis. Herpes simplex keratitis should remain on the clinician's differential diagnosis for patients who present with a corneal epithelial irregularity and decreased visual acuity following DMEK.
Key Words: Descemet membrane endothelial keratoplasty;Herpes;Valacyclovir


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