Conjunctival flap covering combined with antiviral and steroid therapy for severe herpes simplex virus necrotizing stromal keratitis.

Abstract	Herpes simplex virus (HSV) necrotizing stromal keratitis is a common type of herpetic stromal keratitis (HSK). Antiviral medication alone cannot control the disease, and corticosteroid eye drops may aggravate the ulcer and result in corneal perforation. Amniotic membrane transplantation effectively treats superficial corneal ulcer resulting from necrotizing stromal HSK. However, the efficacy of this approach seems to be limited for more serious cases. This study presented the clinical treatment of severe HSV necrotizing stromal keratitis (ulcer depth greater than half of the corneal stroma) by conjunctival flap covering surgery in 25 patients (25 eyes) combined with antivirus and corticosteroid treatment at Shandong Eye Hospital from January 2007 to December 2013. Clinical results showed that the mean best spectacle-corrected visual acuity improved from preoperative 20/333 to postoperative 20/40 (P < 0.05). All patients recovered ocular surface stabilization. There was recurrence in two eyes, which was cured with antiviral medication. Conjunctival flap covering combined with antivirus and corticosteroid treatment is effective in treating severe HSV necrotizing stromal keratitis.
Authors	Hua Gao, Yanni Jia, Suxia Li, Ting Wang, Yaohong Tan, Weiyun Shi
Journal	TheScientificWorldJournal (ScientificWorldJournal) Vol. 2015 Pg. 565964 ( 2015) ISSN: 1537-744X [Electronic] United States
PMID	25785282 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Adrenal Cortex Hormones Antiviral Agents
Topics	Adrenal Cortex Hormones (administration & dosage) Adult Aged Antiviral Agents (administration & dosage) Combined Modality Therapy Conjunctiva (surgery) Corneal Stroma (pathology) Corneal Ulcer (drug therapy, pathology, surgery) Female Humans Keratitis, Herpetic (drug therapy, pathology, surgery) Male Microscopy, Confocal Middle Aged Recurrence Surgical Flaps Visual Acuity Young Adult

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