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

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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

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Nölle.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



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.