Effect of topical FK506 used alone or combined with keratoplasty on patients with recurrent Mooren's corneal ulcer.
OBJECTIVE
To evaluate the efficacy of topical 0.1% FK506 used alone or combined with keratoplasty on patients with recurrent Mooren's ulcer.


METHODS
This is a retrospective interventional consecutive case series. Nine patients (15 eyes) with recurrent Mooren's ulcer were treated with topical 0.1% FK506 alone or combined with keratoplasty. Two eyes with ulcers involving less than half the corneal limbus were treated with topical 0.1% FK506. Of the other 13 eyes with ulcers involving more than half the limbus, twelve were treated with excision of the ulcer and adjacent conjunctiva combined with lamellar keratoplasty. One eye with a central impending corneal perforation was treated with penetrating keratoplasty. Topical 0.1% FK506 was given post-operatively to all thirteen eyes after re-epithelia-ligation of the cornea. FK506 levels in the surgically resected cornea and conjunctiva of the operated eyes were measured using enzyme immunoassay procedures. Twelve patients (17 eyes) with recurrent Mooren's ulcer treated with lamellar keratoplasty combined with topical 0.1% dexamethasone were taken as the control. The main measure of the outcome was the recurrence of Mooren's ulcer in the patients.


RESULTS
Nine patients (15 eyes) with recurrent Mooren's ulcer were all successfully treated. Vision in 5 eyes improved by two lines or better after treatment. No recurrence was observed during the follow up period of 12 to 22 months. After topical application of 0.1% FK506, concentrations of 30 to approximately 350 ng/g of FK506 were found in the cornea and conjunctiva. Seven eyes of Mooren' s ulcer in the control group recurred during the follow up period.


CONCLUSIONS
Topical 0.1% FK506 used alone or combined with keratoplasty is a safe and effective therapy for patients with recurrent Mooren's ulcer.
Xie
Hanping
H
Eye Center, Southwest Hospital, Third Military Medical University, Shapingba, Chongqing 400038, China.
Chen
Jiaqi
J
Lin
Yueshen
Y
Liu
Yongming
Y
Ye
Chentian
C
Zhou
Shiyou
S
D060433:Administration, Ophthalmic; D000328:Adult; D000368:Aged; D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D016559:Tacrolimus