Topical heparin in the treatment of ligneous conjunctivitis.
BACKGROUND
Ligneous conjunctivitis is a rare acute or subacute membranous conjunctivitis of unknown etiology for which no generally accepted form of treatment is available.


METHODS
Between 1972 and 1993, 17 patients with ligneous conjunctivitis were treated with excision biopsy, meticulous hemostasis, and immediate, intensive topical treatment with heparin, steroids, and, in 12 patients, alpha-chymotrypsin until all signs of conjunctival inflammation had subsided.


RESULTS
On histologic examination, the lesions consisted of subepithelial deposits of fibrin in all patients. Eight patients had no recurrence (mean follow-up, 33.1 months) and in four patients the conjunctivitis was controlled after one repeat excision and topical treatment (mean follow-up, 40.3 months). One patient had three recurrences before responding to treatment (follow-up, 24 months). In four patients, treatment was unsuccessful, although lesion-free intervals were longer than usually seen in this condition (mean, 7.8 months).


CONCLUSIONS
These results suggest that intensive and early use of topical heparin may improve therapy results in ligneous conjunctivitis.
De Cock
R
R
Moorfields Eye Hospital, London, England, UK.
Ficker
L A
LA
Dart
J G
JG
Garner
A
A
Wright
P
P
D000208:Acute Disease; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002918:Chymotrypsin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000473:pathology / Q000601:surgery; D003231:Conjunctivitis / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006493:Heparin / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D008566:Membranes / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009883:Ophthalmic Solutions; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D006493:Heparin; D002918:Chymotrypsin