gms | German Medical Science

To analyse the structure of corneal lesion and kind of keratoplasty, performed at patients with herpetic keratitis.

The analysis of 295 keratoplasty, performed at patients with herpetic keratitis is carried out. The age of patients was from 7 till 78 years (43,85 SD15,65), including 116 patients elder, than 50 years, and 45 patients – elder than 60 years.

In analyzable group 195 patients were in an acute stage of the disease, corneal perforation was observed at 70 patients, descemetocele – at 23, corneal ulcer – at 70 patients, stromal keratitis with infiltration – at 32. 100 patients had outcomes of herpetic keratitis, including adherent vascular leukoma at 21, not adherent vaskular leukoma – at 67, postherpetic keratopathy – at 7 patients, corneal avascular leucoma – at 5. 267 patients (90,51%) had recurrent process, 28 (9,49%) – primary process. Lamellar keratoplasty was perforemed at 177 patients, biological covering by Puchkovskaya – at 49 patients, penetrating keratoplasty - at 69 patients. When it was necessary, we have performed combinations of different kinds of keratoplasty, and also keratoplasty and kataract extraction, synechotomy, antiglaucomatous operations etc.

Our experience shows, that in acute keratitis at patients with herpetic keratitis lamellar keratoplasty is the method of a choice. Lamellar keratoplasty in combination with adequate medicamentous therapy gives us possibility to stable inflammatory process, to avoid such serious complications as a secondary glaucoma and reaction of transplantation and to save the eye. Taking into account such feature of herpetic keratitis, like recurrences, which at patients with heavy forms of disease are observed more, than in 50% of cases, the more easy possibility to repeat lamellar keratoplasty is also very important. The lamellar keratoplasty is especially good at elder persons with accompanying somatic diseases.