Open AccessHSV-1 in a case of intractable glaucoma with rapid progress of cataract after transscleral cyclophotocoagulation
Author(s) -
Hui-Chuan Chung,
I-Lun Tsai,
ChingYao Tsai,
ShiowWen Liou,
LinChung Woung
Publication year - 2011
Publication title -
taiwan journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.519
H-Index - 9
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.1016/j.tjo.2011.09.002
Subject(s) - medicine , trabeculectomy , ophthalmology , intraocular pressure , glaucoma , corneal perforation , glaucoma surgery , uveitis , aqueous humor , herpes simplex virus , surgery , visual acuity , virus , virology
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