Surgery treatment of purulent corneal ulcers associated with neuroparalytic keratitis

Abstract

The study objective was to develop a method for surgical treatment of advanced purulent corneal ulcer in the setting of neuroparalytic keratitis developed after acoustic neuroma removal and strokes. The study included 12 patients (13 eyes). All patients underwent single-step keratoplasty, conjunctival autografting, and partial permanent tarsorrhaphy. The eye as an organ was spared in 100% of cases; vision was spared in 50% of cases and improved, from 0.09±0.05 to 0.21±0.13, in 29% of cases. Lagophthalmos was reduced from 5.86±1.35 to 3.01±0.75 mm. Patients with intracranial lesions complicated by neuroparalytic keratitis often develop progressive purulent corneal ulcers. The simultaneous use of surgery, including keratoplasty, conjunctival autografting, and partial (external) tarsorrhaphy, is an effective treatment that can preserve the visual function of these eyes.