Outcome of treatment of mooren ulcer with topical cyclosporine a 2%

Abstract

Purpose: To study the clinical outcome of treatment of Mooren ulcer with topical cyclosporine A (CsA) 2% as an adjunct to standard therapy.

Methods: Seventeen eyes of 15 patients with Mooren ulcer treated with CsA 2% eyedrops were included. Five eyes had undergone a full-thickness patch graft for perforation and were started on topical CsA therapy after surgery. Topical CsA had been started in the other 12 eyes as an adjunct to standard medical therapy after treatment failure. Clinical efficacy was evaluated on the basis of reduction in lesion size, healing of the epithelial defect, visual recovery, and recurrence rate.

Results: In 12 eyes to which topical CsA had been given as an adjunct therapy, the ulcers had resolved completely with various degrees of vascularization. The mean healing time including complete epithelization was 34.4 +/- 13.1 days (range, 14-56 days). During the follow-up period of 12 months, recurrence had been observed in 1 patient. No recurrence of the ulcer was seen in the 5 eyes that were started on topical CsA therapy after tectonic keratoplasty. A significant (P = 0.004) improvement was seen in the mean best-corrected visual acuity from the pretreatment values at 12 months. No adverse effects attributable to CsA were observed.

Conclusions: Topical 2% CsA therapy can be a safe and useful adjunct to standard medical therapy in recalcitrant cases of Mooren ulcer.