New etiological factors of complications after excimer laser correction of ametropia

Background. Nowadays, excimer laser correction of ame­tropia is an extremely common intervention, given the prevalence of refractive errors among population and their impact on quality of life. Despite the constant development of technologies, tho­rough patient selection and comprehensive preoperative examination, complications happen after using all excimer laser correction methods. The purpose is to investigate new etiological factors of corneal complications after excimer laser correction of ametropia. Materials and methods. The study involved 245 patients (490 eyes) with myopia and myopic astigmatism aged 18 to 40 years. Three observation groups were formed depending on the method of excimer laser correction. All patients underwent determination of the level of immunoglobulins (Ig) M and G to herpes virus type 1 and 2, as well as to herpes virus type 5 (cytomegalovirus) in blood serum by enzyme-linked immunosorbent assay in the Synevo laboratory. The nature and frequency of complications in the postoperative period were monitored and the relationship between the frequency of these complications and the studied indicators was analyzed. The observation period was 3 months. Results. 87.7 % of patients from all 3 observation groups, in whom complications were detected in the postoperative period, have significantly increased serum IgM and G to herpes simplex virus type 1 and 2 and cytomegalovirus. In contrast, among those who did not experience complications in the postoperative period, only 26 % had increased serum IgM and G to herpes simplex virus type 1 and 2 and cytomegalovirus. It is important to note that the titers of the above antibodies among patients without complications slightly deviated from the normative values, while in the group with complications, these titers considerably exceeded the norm, which is statistically significant. Conclusions. As a result of the study, we found that asymptomatic latent herpes and cytomegalovirus infection is a factor that increases the risk of corneal complications after various types of excimer laser correction of ametropia. Therefore, routine determination of specific immunity titers to herpes simplex virus and cytomegalovirus at the preoperative stage may be useful in clinical practice.