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Surgical treatment of purulent corneal ulcers in patients with neurotrophic keratitis and lagophthalmos

Poster Details

First Author: E.Kasparova RUSSIA

Co Author(s):    E. Kasparova   B. Yang   A. Kasparov              

Abstract Details


To describe a surgical method for the treatment of purulent corneal ulcers in patients with neuroparalytic keratitis that has developed as a complication of intracranial lesions and/or brain surgery. As a result, patients suffered extensive n.trigeminus and n.facialis damage.


FGBNU State Research Institute on Eye Diseases, Moscow, Russia


We observed 13 patients (14 eyes). Surgical management included combination of therapeutic keratoplasty, covered by Gunderson conjunctival flap and partial tarsorrhaphy. Before and after surgery, patients received frequent instillations of antimicrobial agents and instillations of autologous serum


Our method proved to be effective in preserving eye integrity in all cases. We managed to preserve visual function in 50% of the cases and to increase visual acuity in 35.7% of them. Visual acuity increased from 0.07±0.05 tо 0.26±0.11 (decimal). Lagophthalmos decreased from 6.11±0.99 to 2.78±0.62 mm.


Patients with intracranial lesions complicated by neurotrophic keratitis often suffer serious and progressive corneal purulent ulcers, corneal melting, which often do not respond to the most active conservative therapy. The combined surgery addresses all pathogenetic components of that pathology – corneal ulceration, melting (keratoplasty), impairment of healing, ( autoconjunctival graft), lagophthalmos (partial tarsorrhaphy). Preop and post-operative conservative therapy included frequent instillations of antimicrobial agents and the use of autologous blood serum, that prevented disease progression and promoted healing.

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