Efficacy of conjunctival resection with cyanoacrylate glue application in preventing recurrences of Mooren's ulcer

Abstract

Aim: To evaluate the role of conjunctival resection along with cyanoacrylate glue and bandage contact lens application in preventing recurrences and arresting progression in cases of Mooren's ulcer.

Method: This retrospective interventional case series included cases of Mooren's ulcer that underwent conjunctival resection with cyanoacrylate glue and bandage contact lens application between 2011 and 2014. Systemic immunosuppression was initiated depending on the laterality and severity of disease. The primary outcome measures were clinical quiescence and recurrence-free survival. Kaplan-Meier plots were constructed and survival analysis done using the R software environment for statistical analysis. Secondary outcome measures were needed for systemic immunosuppression, change in best-corrected visual acuity and complications encountered.

Results: We evaluated 16 eyes of 12 patients who presented to us during the study period. The mean follow-up duration was 9.6 months. All eyes achieved clinical quiescence with a median recurrence-free survival of 141 days. The Kaplan-Meier survival curve showed probability of recurrence-free survival to be 42.5% at 1 year, which further dropped down to 21.3% at 2 years. All patients with recurrence (seven eyes of four patients) required systemic immunosuppression.

Conclusions: Conjunctival resection and cyanoacrylate glue application are not effective in avoiding recurrences and halting the disease progression in cases of Mooren's ulcer. Systemic immunosuppression remains the mainstay of therapy.

Keywords: Cornea; Inflammation; Treatment Surgery.