Case Reports
Vol. 31 No. 1 (2024)
https://doi.org/10.4081/ltj.2024.397

Keratorefractive lenticule extraction in eyes with post-herpetic scars

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Received: 18 March 2024
Accepted: 2 June 2024
Published: 1 July 2024
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Keratorefractive Lenticule Extraction (KLEx), myopia, herpes simplex virus, keratitis

Authors

Antonio Leccisotti
leccisotti@libero.it
https://orcid.org/0000-0001-9953-0535
Siena Eye Laser, Poggibonsi, Siena, Italy; School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom.
Stefania V. Fields
Siena Eye Laser, Poggibonsi, Siena, Italy.
Giuseppe De Bartolo
Siena Eye Laser, Poggibonsi, Siena, Italy.
Christian Crudale
https://orcid.org/0009-0006-4002-1481
Siena Eye Laser, Poggibonsi, Siena, Italy.
Matteo Posarelli
Siena Eye Laser, Poggibonsi, Siena, Italy; Liverpool University, United Kingdom.

Correcting refractive errors by remodeling the corneal curvature with an excimer laser (which emits ultraviolet radiation) may reactivate a latent Herpes Simplex Virus (HSV), resulting in keratitis. New techniques using infrared sources, such as femtosecond-assisted Keratorefractive Lenticule Extraction (KLEx), may thus provide a safer approach to eyes with previous HSV keratitis; however, no cases of KLEx in such cases have been reported. As a result, we present three cases in which KLEx successfully corrected myopia. Three myopic eyes from three patients with a known history of healed HSV keratitis that occurred more than 12 months before surgery underwent KLEx. All patients received oral antiviral prophylaxis before and after surgery. In case 1, the post-HSV scar was semiperipheral, involving only a portion of the treated area; surgery went smoothly, with the intrastromal lenticule well delineated and dissected even through the scar. In cases 2 and 3, the healed scar was peripheral and did not interfere with surgery. After 6 months, all three cases had good visual acuity without complications. Finally, KLEx combined with antiviral prophylaxis can effectively correct myopia in eyes with healed HSV. The femtosecond laser can penetrate non-dense, peripheral corneal scars.

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Ethics Approval

The study has been granted an exemption from requiring ethics approval by the Institutional Review Board at Siena Eye Laser. Ethical approval is not required for this study in accordance with national guidelines.

CRediT authorship contribution

Antonio Leccisotti, Stefania V. Fields: conceptualization, writing – original draft; Giuseppe De Bartolo, Matteo Posarelli: data analysis, writing – review & editing; Christian Crudale: conceptualization, data analysis. All the authors read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work.

Data Availability Statement

All data generated or analyzed during this study are included in this published article.

How to Cite



Leccisotti, A., Fields, S. V., De Bartolo, G., Crudale, C., & Posarelli, M. (2024). Keratorefractive lenticule extraction in eyes with post-herpetic scars. Laser Therapy, 31(1). https://doi.org/10.4081/ltj.2024.397
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