HSV-1 in a case of intractable glaucoma with rapid progress of cataract after transscleral cyclophotocoagulation |
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| Authors: | Hui-Chuan Chung I-Lun Tsai Ching-Yao Tsai Shiow-Wen Liou Lin-Chung Woung |
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| Institution: | 1. Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan;2. Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan;3. Department of Ophthalmology, Taipei Medical University, Taipei, Taiwan;4. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan |
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| Abstract: | A 22-year-old female patient received penetrating keratoplasty (PK) of her right eye for ocular rosacea complicated with corneal perforation. Intraocular pressure (IOP) fluctuated and could not be well controlled by full antiglaucomatous agents after surgery. Therefore transscleral diode laser cyclophotocoagulation (TSCPC) was performed for the intractable glaucoma one year after PK. Unfortunately, acute cataract formation was noted 50 days after the laser treatment. Pigmented keratic precipitates (KPs) developed and IOP rose subsequently. Cataract extraction with intraocular lens implantation combined with trabeculectomy was performed 3 months later. Polymerase chain reaction (PCR) tests of the aqueous humor to detect cytomegalovirus (CMV) and herpes simplex virus (HSV) were negative. However, HSV type I DNA was detected in the lenticular material and excised trabecular tissue. Trabeculitis caused by herpetic infection could be the reason of fluctuated and intractable IOP elevation. The virus hidden in the intraocular tissue could be reactivated by TSCPC and result in cataract formation. Therefore, performing TSCPC in a phakic eye with atypical IOP presentation should be undertaken with caution. |
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