Unilateral Peripheral Ulcerative Keratitis Treated With Glue + Conjunctival Resection

PUK is an infrequent but somewhat serious entity in the pathology of the ocular/corneal surface. It usually requires a powerful specialized treatment that includes local, systemic and surgical therapies to stop the progression of the disease.

A differential diagnosis should be made with Mooren's ulcer.Surgical treatment is part of the armament available to treat the entity and we describe its action in 3 patients

Patients diagnosed with peripheral ulcerative keratitis without associated severe systemic pathology treated in a hospital environment and in private practice in Barcelona, with good final results

We describe 3 cases diagnosed with peripheral ulcerative keratitis with no known systemic disease after extensive laboratory studies, and without previous surgery, which after progressing to significant thinning in the peripheral cornea, treatment with systemic immunosuppressants (cyclophosphamide and mycophenolate mofetil) plus application of cyanoacrylate and resection of the adjacent conjunctiva are prescribed.

Immunosuppressive treatment could not be initiated or had to be discontinued even in infratherapeutic doses due to associated systemic pathology, and we observed a good evolution of the clinical picture with only surgical treatment and doses of steroids in eye drops.

The final outcome was control of the corneal entity with residual astigmatsiom and mild corneal thinning in the affected area and no significant loss of visual acuity.

Cyanoacrylate glue associated with conjunctival resection of the area adjacent to the lesion can halt and/or cure, in some cases, the progression of peripheral ulcerative keratitis without the need to associate systemic immunosuppressive drugs.