gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Conservative and surgical treatment options in corneal ulcers

Meeting Abstract

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  • corresponding author B. Nölle - Dept. of Ophthalmology, University Clinic of Schleswig-Holstein, Campus Kiel

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.16.10

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Veröffentlicht: 22. September 2004

© 2004 Nölle.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Various factors possibly lead to corneal ulcerations. These are infections, autoimmune reactions, dry eye syndrome, neurotrophic problems, injuries, or lid abnormalities. With concern to these heterogeneic factors multiform treatment options are available. Three basic principles should be considered in corneal ulcer treatment:

1. optimization of ocular surface treatment;

2. systemic immunosuppression in severe autoimmune inflammation;

3. eye microsurgery.

Ad 1: Surface treatment encloses rehabilitation of lid closure, artificial substances to moisten ocular surface, autologous serum drops, topical treatment with vitamin A, corticosteroids, or ciclosporin A, therapeutic contact lenses, botulinum toxin, tarsorrhaphy, and amniotic membrane transplantation.

Ad 2: Systemic immunosuppression can be induced with alkylating substances, inhibitors of purin synthesis, folic acid antagonists, immunophilines, or biologicals like TNF-a-inhibitors.

Ad 3: Surgical methods include conjunctival autografts, limbal autografts, keratoepithelioplasty, phototherapeutic keratectomy, Goretex® patch, lamellar keratoplasty, amniotic membrane transplantation, or penetrating keratoplasty.

Various treatment options will be outlined with representative clinical cases. These cases allow to recognize escalating treatment options depending on time, geometry of corneal ulcer (depth, localization) and availability of tissue for grafting.