To present a case of corneal perforation
secondary to herpes simplex reactivation after laser in situ keratomileusis (LASIK
) and its subsequent management.
A case report of a 69-year-old man who underwent LASIK
after penetrating keratoplasty
for herpes simplex keratitis
(HSK) is presented.
The patient is a 69-year-old man who had a penetrating keratoplasty
of the right eye 6 years prior for corneal scarring secondary to HSK. A spectacle refraction of −13.25 + 6.00 × 45 yielded 20/60 visual acuity in his grafted eye. LASIK
was performed, and the patient’s visual acuity without correction on postoperative day 1 was 20/60. Ten days after LASIK
, the patient developed thinning of the cornea at the temporal edge of the flap, which perforated the following day. The perforation
site was glued with cyanoacrylate adhesive
and covered with a soft contact lens. After 7 months, a 4-mm lamellar keratoplasty and conjunctivoplasty was performed. Nine months after surgery, the patient’s visual acuity without correction is 20/50 and the graft remains intact.
Conclusion. Herpes simplex keratitis
may be a contraindication for LASIK
in postkeratoplasty patients. Bandage contact lenses and cyanoacrylate adhesive
can be used successfully to manage the rare complication of corneal perforation