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Efficacy of Conjunctival Resection with Cyanoacrylate Glue Application in the Treatment of Mooren’s Ulcer Jayesh Vazirani Merle Fernandes L V Prasad Eye.

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Presentation on theme: "Efficacy of Conjunctival Resection with Cyanoacrylate Glue Application in the Treatment of Mooren’s Ulcer Jayesh Vazirani Merle Fernandes L V Prasad Eye."— Presentation transcript:

1 Efficacy of Conjunctival Resection with Cyanoacrylate Glue Application in the Treatment of Mooren’s Ulcer Jayesh Vazirani Merle Fernandes L V Prasad Eye Institute Visakhapatnam, India Jayesh Vazirani Merle Fernandes L V Prasad Eye Institute Visakhapatnam, India The authors have no financial interests to disclose

2 Purpose To study the efficacy of conjunctival resection with cyanoacrylate glue application in the treatment of Mooren’s ulcer

3 Methods Study design: Retrospective, non-randomized, interventional case series Study population: Eyes with clinically determined Mooren’s ulcer, which underwent conjunctival resection with cyanoacrylate glue application Intervention: A 3-4 mm wide strip of conjunctiva extending at least 1 clock hour beyond the margin of ulcer on either side was resected and cyanoacrylate glue was applied to the peripheral cornea. Post-operative treatment included topical steroid in all cases

4 Methods Outcome measures: Clinical quiescence, determined as cessation of further ulceration and infiltration, complete epithelization and no clinical evidence of inflammation. Survival rate, calculated from recurrence-free interval and total follow-up duration Statistical analysis: A Kaplan-Meier survival curve was constructed and survival probability was reported in percentages. Multivariate Cox proportional hazards model analysis was done to determine association between clinical factors and risk of recurrence

5 Results Sixteen eyes (eight unilateral cases and four bilateral cases) with Mooren’s ulcer underwent this procedure. Clinical quiescence was initially achieved in all eyes. Recurrence of disease was noted in 5 eyes (31.25%).

6 Results Case No. Age (Years) GenderEyeLaterality Baseline Visual Acuity Clock hrs of involvement 1 38MODBilateral20/ MOSBilateral20/ MODUnilateralCF MOSBilateralPL1 5 74MODBilateral20/ MOSUnilateralPL2 7 60MOSBilateral20/ MODBilateralCF MODUnilateralCF MOSUnilateral20/PL FOSUnilateral20/ MODBilateral20/ MOSBilateral20/ MODUnilateral20/ MODUnilateralCF MODUnilateral20/4005

7 Results Case No. Follow up (Days)Recurrence Time to recurrence (Days) Recurrence-free Survival (Days) 1 30No30 2 No No No85 5 No No Yes Yes Yes No No Yes Yes No No No630

8 Results Median follow-up 136 days (Range days) Mean survival probability 58.3% (standard error 14.81%) Median survival time days (Range days)

9 Survival Curve

10 Results Multivariate analysis Bilaterality - only factor significantly affecting chances of recurrence Hazards ratio (95% confidence intervals ) (p- 0.02) All recurrences were successfully treated with systemic steroid and/or immunomodulatory drugs.

11 Conclusions Conjunctival resection with cyanoacrylate glue application provides tectonic stability, but is of limited value in preventing recurrences of Mooren’s ulcer. Bilateral cases have a much higher risk of recurrence than unilateral cases.

12 Thank You L V Prasad Eye Institute Excellence  Equity  Efficiency


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