Abstract
IntroductionMooren's ulcer is a rare disorder of unknown etiology that is refractory to treatment. It can affect not just the cornea but also the scleral tissue and can involve both eyes.Case presentationWe report a case of a 74-year-old man with a history of bilateral and malignant Mooren's ulcer. The patient had undergone an exenteratio bulbi of the left eye because of the perforation of a Mooren's corneal ulcer. The perforated Mooren's corneal ulcer also presented in the right eye and involved the adjacent scleral tissue. It was decided to perform a corneal-scleral graft to preserve the anatomical integrity of the eye.ConclusionThis report highlights how a corneal-scleral graft followed by systemic and local immunosuppressive treatment should be considered in monocular patients with malignant Mooren's ulcer where there is serious damage to the corneal and scleral tissue.
Highlights
Mooren's ulcer is a rare disorder of unknown etiology that is refractory to treatment
This report highlights how a corneal-scleral graft followed by systemic and local immunosuppressive treatment should be considered in monocular patients with malignant Mooren's ulcer where there is serious damage to the corneal and scleral tissue
When the cornea and the sclera is involved in eye perforation it can be necessary to perform a large corneoscleral graft to save the eye
Summary
Mooren's ulcer is a rare disorder involving the chronic and painful ulceration of the cornea. As well as the cornea, the sclera can be involved with an incidence of 13.5% of eye perforation and loss of vision [1]. When the cornea and the sclera is involved in eye perforation it can be necessary to perform a large corneoscleral graft to save the eye. We describe a case of anterior segment reconstruction using corneoscleral grafts of 14 mm in diameter in a patient with Mooren's ulcer and eye perforation. Systemic treatment with cortisone failed to prevent the progression of the disorder and perforation of the right eye and, a corneoscleral graft was necessary. The entire cornea and scleral ring was removed, viscoelastic material was placed on the recipient bed and a large anterior capsulorhexis was performed. The best corrected visual acuity was 6/60 (Figure 2)
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