Retrospective analysis of full-thickness penetrating keratoplasty in herpetic keratitis patients

Analyze patients with severe herpetic keratitis, where anterior segment reconstructive surgery - full-thickness penetrating keratoplasty was performed. Retrospective case summary analysis and interpretation of patients with severe herpetic keratitis treated with full-thickness keratoplasty in Pauls Stradins Clinical University Hospital from year 2016 to 2020. Patients were divided in two groups according to the clinical manifestation of herpetic keratitis. During 4 years from 2016 to 2020 total 117 full-thickness penetrating keratoplasty surgeries were performed. Together 8 patients (6.8%) with active or previously diagnosed herpetic keratitis were included in the study. Severe, active herpetic keratitis with corneal ulcer perforation was diagnosed in 4 cases, whereas other 4 patients have had herpetic keratitis in medical history. Distinctive complication of herpetic keratitis is corneal sensitivity loss, which more often results in neurotrophic corneal ulcer. Neurotrophic ulcer perforation and previous herpes zoster keratitis in medical history was the main reason of full-thickness corneal transplantation in other half of patients in the study group. Noteworthy fact is the difference in post-surgical treatment, where anti-viral drugs play general role in active herpetic keratitis, in the same time ocular surface lubrication in neurotrophic keratitis. Acute herpetic keratitis as well as neurotrophic keratitis induced by previous herpes virus corneal infection are challenging cases in ophthalmology, which demands special approach in order to achieve satisfying outcome.