Background: Moorenââ?¬â?¢s ulcer is a severe ulcerative inflammation of the cornea. The exact pathogenesis remains\r\nunclear. Therefore many therapies of Moorenââ?¬â?¢s ulcer are recommended in literature. To shed more light on the\r\nongoing question of optimal treatment of severe progressive Moorenââ?¬â?¢s ulcer, we here report on a retrospective\r\ncase series of patients treated with systemic immunosuppressive therapy and additional amniotic membrane\r\ntransplantation.\r\nMethods: Medical records from seven patients (eleven eyes), 4 male and 3 female, with severe progressive\r\nMoorenââ?¬â?¢s ulcer were analysed retrospectively. The mean follow up was 88.4 Ã?± 80.8 months (range 12ââ?¬â??232 month).\r\nA HLA-typing was performed in all patients. A systemic immunosuppressive therapy was administered in all\r\npatients. The amniotic membrane was transplanted after the base of the ulcer was resected.\r\nResults: Multiple amniotic membrane transplantations were necessary in six patients. The visual outcome of all\r\npatients was poor. No patient achieved a visual acuity better than 20/630 Snellen chart. Five patients were positive\r\nfor HLA-DQ2 and four patients were positive for HLA-DR17(3).\r\nConclusions: The aggressive and highly inflammatory form of Moorenââ?¬â?¢s ulcer is difficult to treat and the\r\nprogression of the disease is hard to influence positively even under systemic immunosuppressive therapy.\r\nTherefore, the main intention of therapy is to achieve a stable epithelialized corneal surface without the risk of\r\nperforation. Amniotic membrane transplantation is not able to cure severe forms of Moorenââ?¬â?¢s ulcer. However it\r\nsupports the immunosuppressive therapy in acute situations as in critical corneal thinning.
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