Abstract:  Objective To discuss the clinical characteristics and treatments of herpes simplex keratitis (HSK) after phacoemulsification. Design Retrospective case series. Participants Twelve patients (15 eyes) who presented in Eye Hospital of Wenzhou Medical College with HSK after cataract surgery from April 2005 to August 2012. Method All patients data including demographic informations, clinical classification（Holland diagnostic classification), history of surgery, treatment protocols and duration, were reviewed retrospectively. Epithelial keratitis were treated with oral acyclovir, ganciclovir gel and preservative-free artificial tears. The stromal and endothelial keratitis were treated with intravenous acyclovir and dexamethasone followed by oral acyclovir and prednisone, 0.02% fluorometholone and topical autohemotherapy. Main Outcome Measures Clinical classification, symptoms, signs and duration of the disease. Results Twelve patients (15 eyes) presented with different stage of HSK between 3 days and 4 weeks after cataract surgery. There were 5 patients（6 eyes） with epithelial keratitis and 7 patients（9 eyes）with stromal and endothelial keratitis. All patients presented with redness，pain，foreign body sensation，photophobia，tearing and decreased vision after surgery. Visual acuity of patients with epithelial HSK improved from 0.3~0.6 to 0.6~0.8 after treatment and duration of disease was between 1~3 weeks. In patients with stromal and endothelial HSK, visual acuity improved from hand motion ~ 0.6 to counting finger ~ 0.9 after treatment with a duration of disease between 1~3 months. Conclusion Because the prevalence of HSK after cataract surgery is lower, it can be easily misdiagnosed. Duration of HSK after cataract surgery was related to the extent of the corneal lesion. It is important for visual function restoration to diagnose in time and treat adequately in patients with HSK after cataract surgery .

Key words: cataract/surgery, phacoemulsification, herpes simplex keratitis