Effect Of Latent Virus Infection In Cornea On Corneal Healing After SMILE

Purpose To detect the positive rate of virus latent infection in the corneal stromal lens after SMILE,analyze the effect of virus latent infection in the cornea on corneal healing after SMILE,and provide theoretical guidance for postoperative medication in patients with positive lens virus test during SMILE.Methods A total of 279 patients who received SMILE for correction of ametropia in The First Affiliated Hospital of USTC from January 2022 to October 2022 were selected.Fluorescence quantitative polymerase chain reaction(FQ-PCR)was used to detect latent virus infection in the stromal lens taken out of SMILE,including herpes simplex virus type 1(HSV-1),herpes simplex virus type 2(HSV-2),Epstein-Barr virus(EBV)and cytomegalovirus(CMV).And the positive results were included in the positive group and the negative ones in the control group.Compare the postoperative visual acuity,spherical equivalent,intraocular pressure,corneal curvature K1 and K2,corneal transparency,corneal staining,number of corneal stromal cells,number of corneal inflammatory cells,corneal nerve fiber density(CNFD),corneal nerve branch density(CNBD),corneal nerve fiber length(CNFL),corneal total branch density(CTBD),corneal nerve fiber width(CNFW)of the two groups,then analyze the effect of virus latent infection in cornea on corneal healing after SMILE.Results In this study,a total of 240 herpes simplex virus(HSV)samples were detected,of which 11(4.58%)were HSV positive,among which 5(2.08%)were HSV-1 positive,6(2.50%)were HSV-2 positive,and 229(95.42%)were HSV negative.A total of 91 samples of EBV were detected,all of which were negative.CMV samples were detected in 91 cases,all of which were negative.A total of 240 patients(470 eyes)underwent HSV test were included,including 11 patients(21 eyes)in the positive group and 229 patients(449 eyes)in the control group.There was no statistical significance in postoperative visual acuity,spherical equivalent,intraocular pressure,corneal curvature K1 and K2,corneal transparency and corneal staining between the two groups(P>0.05).A total of 26 patients(36 eyes)underwent HSV test and corneal confocal microscopy were included,including 11 patients(21 eyes)in the positive group and 15 patients(15eyes)in the control group.There was no statistical significance in postoperative visual acuity,spherical equivalent,intraocular pressure,corneal curvature K1 and K2,corneal transparency and corneal staining between the two groups(P>0.05).There was no significant difference in number of corneal stromal cells,number of corneal inflammatory cells,CNFD,CNBD,CNFL,CTBD,CNFW(P>0.05).Conclusion There is a certain proportion of latent HSV infection in SMILE patients with normal physical examination,suggesting that attention should be paid to the preservation and safety of stromal lens when it is reused.Femtosecond laser is less likely to activate latent infection of HSV in cornea.The latent infection of HSV had no significant effect on corneal healing after SMILE,and did not increase the risk of infectious keratitis,further proving the safety of SMILE.