OBJECTIVETo evaluate the role of acyclovir in treatment and prevention of herpes simplex keratitis (HSK).

METHODSA total of 105 patients with HSK were divided into 4 groups. Group 1 consisted of 79 patients with HSV epithelial keratitis. Group 2 consisted of 20 patients with interstitial keratitis. Group 3 consisted of 6 patients with necrotizing keratitis. Group 4 consisted of 4 necrotizing keratitis patients with corneal perforation treated with conjunctival flap and corneal transplantation. All patients were treated with acyclovir systemically and topically. After full recovery, the patients with epithelial HSK and stromal HSK were randomly divided into two groups individually. One group was constantly treated with oral acyclovir at 300 mg/day for 1 year as a prophylaxis group. The other group was designated as control.

RESULTSDuring the one-year treatment and follow-up, 5 cases with epithelial HSK recurred in the prophylaxis group and 14 cases in the control group, showing a statistically significant difference. One case of stromal HSK recurred in the prophylaxis group and 4 recurred in the control group.

CONCLUSIONLong term and low dose oral acyclovir for prophylaxis of recurrent epithelial herpes simplex infection and therapeutic doses of oral acyclovir reduce both the rate and duration of recurrences of infectious herpes simplex keratitis.