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LASIK safe in patients with history of ocular herpes

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Patients with a history of ocular herpes can safely undergo LASIK, according to a retrospective study by researchers in Spain. No patients experienced a reactivation of herpetic keratitis during the follow-up period, the study authors noted.

"Candidates should be selected with caution and surgery performed only in eyes in which the herpes has been inactive for 1 year before surgery, without stromal disease, and with regular topography and pachymetry maps and normal corneal sensitivity," the authors said. "The most reasonable clinical strategy is perioperative systemic antiviral prophylaxis."

Victoria de Rojas Silva, MD, PhD, and colleagues reviewed outcomes for 49 eyes of 48 LASIK patients with a history of either ocular herpes simplex virus (HSV) or herpes zoster ophthalmicus (HZO). They published their results in the November issue of Journal of Cataract & Refractive Surgery.

Specifically, 28 eyes had a history of HSV keratitis, 17 eyes had a history of HSV eyelid lesions and four eyes had a history of HZO. Patients' herpetic diseases were inactive at the time of surgery in all cases and remained inactive for longer than 1 year in 31 eyes, according to the study.

Surgeons completed all LASIK procedures with no intraoperative complications. However, perioperative antiviral systemic prophylaxis was used in 13 HSV keratitis patients, the authors noted.