Conjunctival Flap Covering Combined with Antiviral and Steroid Therapy for Severe Herpes Simplex Virus Necrotizing Stromal Keratitis

Figure 1

Slit-lamp photographs showing the treatment course of severe herpes simplex virus necrotizing stromal keratitis. (a) Patient 1: the preoperative UCVA was 20/200. The average size of ulcers approximately 4 mm × 5 mm. The depth of the corneal ulcer typically exceeds fifty percent of the entire cornea. Evident corneal necrosis can be seen in the surrounding stromal edema. (b) 12 months after single-pedicle conjunctival flap transplantation, the cornea ulcer was completely cured. The central cornea was clear. The patient had UCVA 20/25 and BSCVA 20/20. (c) Patient 2: the preoperative UCVA was 20/400. Conjunctival hyperemia was observed. The average of the ulcer on the infranasal side of the cornea was about 6 mm × 3 mm. The corneal OCT revealed that the ulcer had nearly reached Descemet’s membrane. The surrounding tissue displayed necrosis, infiltration, and edema. (d) 18 months after double-pedicle conjunctival flap transplantation, the corneal ulcer had healed, with the relief of corneal edema, UCVA was 20/63, and BSCVA was 20/32.

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