| 본문 : Purpose
To report two cases of herpes simplex dendritic keratitis after reconstruction surgery of blow-out fracture(BOF).
Case summary
Case 1) A 35-year-old male patient who had been struck by other passerby visited our clinic, and was diagnosed as BOF(Right medial wall). Reconstruction surgery for the patient was done successfully. There were no other abnormal findings on slit lamp examination after the surgery. Cold compression, topical eye-drops, intravenous antibiotics and steroids were applied as post-operative care. The patient was stable and discharged a week later. On outpatient’s basis, dendritic lesions were found on his right cornea twelve days after the surgery. He was diagnosed as herpes simplex dendritic keratitis and treated with antiviral ointment, oral antiviral agent. Six weeks later, the lesions were clearly cured without recurrence.
Case 2) A 35-year-old man came to our clinic for his enophthalmos on his right eye. He had had a car accident while riding a bicycle 5 months ago. At that time, he had underwent reconstruction surgery of blow-out fracture(Right inferomedial walls), nasal bone fracture, and zygomatic fracture on his right face from other hospital of department of plastic surgery. In our hospital, the patient had been undergone additional reconstruction surgeries of blow-out fracture on February 2018, revision surgery of eyelid ptosis on April 2018, and surgery of jones tube intubation on July 2018 due to his enophthalmos, eyelid ptosis, and epiphora. While outpatient’s based follow-ups, there were some dendritic lesions on his right cornea on slit lamp examination on December 2018. He was diagnosed as herpes simplex dendritic keratitis. The patient was treated with antiviral ointment and oral agent. Although keratitis was once recurred, the corneal lesions were finally cured.
Conclusion
Until now, there have been several reports about herpes simplex dendritic keratitis after surgery which manipulate patient’s cornea such as cataract surgery, refractive surgery, penetrating keratoplasty. We report that herpes simplex keratitis can occur after the BOF surgery which does not directly associate with cornea.
Key words(2)
Blow-out fracture, Herpes simplex dendritic keratitis |