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—Dr Freedman suggests that herpes simplex keratitis may have caused the corneal melting after intraocular lens surgery that I described. However, the findings in the five cases reported are inconsistent with this diagnosis.In all cases, the eyes were comfortable, free of pain, and showed little, if any, signs of inflammation. Corneal sensation was intact when tested. Histopathologic examination of the cornea in two cases that required keratoplasty showed minimal inflammatory cell infiltration. Furthermore, electron microscopy of these specimens failed to identify viral organisms. Steroids in the treatment of epithelial herpes keratitis evolving into stromal ulceration would have been expected to enhance, not suppress, the inflammatory process that would have been present.Although the pathophysiologic basis for the corneal melting described remains an enigma, it would seem unlikely that herpes simplex virus is causally related to this condition. I would like to thank Dr Freedman for raising this
Gelender H. Herpes Simplex Virus-Reply. Arch Ophthalmol. 1982;100(7):1177. doi:10.1001/archopht.1982.01030040155029
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