Recurrent Herpes Simplex Keratitis in Penetrating Keratoplasty

Purpose and Methods: Penetrating keratoplasty (PK) in herpes simplex keratitis (HSK) is increasingly performed not only for visual purposes but also to remove viral antigen from the cornea and to reestablish the structural integrity of the eyes. With the improvement of medical management and surgical techniques which lead to a higher survival rate of the graft, PK in HSK still carries a high complication rate postoperatively. These complications include corneal graft rejection, herpes recurrences in the graft, persistent epithelial defect, corneal melting, secondary infection and graft failure. We present a case of recurrent HSK in corneal graft after prophylactic antiviral had been stopped. The role of postsurgical antiviral prophylaxis is discussed. Conclusion: This case supports the use of prophylactic acyclovir 800 mg daily as an effective prevention of recurrent HSK and as a mean of reducing allograft rejection and graft failure after PK in HSK.