Long-term results of keratoepithelioplasty in Mooren's ulcer

Abstract

A consecutive series of 20 eyes with Mooren's ulcer was treated by a new surgical approach: keratoepithelioplasty alone or in combination with corneoscleral lamellar graft. Eighteen (90%) eyes showed complete remission promptly after surgery; the other two also healed with the administration of additional systemic and topical steroids. During the follow-up periods (mean, 3.1 years), minor recurrence was found in 5 (25%) eyes for the first 6 months, in none (0%) for the second 6 months, in 2 (12%) for the third 6 months, and none thereafter. All seven eyes with recurrence were cured by additional steroid treatment, alone or with conjunctival excision and/or keratoepithelioplasty. In the 18 (90%) eyes, the lenticules, constantly observed, remained silent on the scleras, which were free from conjunctival invasion. These results strongly support the authors' theory that keratoepithelioplasty using donor corneal lenticules can heal Mooren's ulcer via blockage of infiltrated conjunctival invasion.