Posters

The challenge of ligneous conjunctivitis: use of sinthetic dura mater and topical enhanced heparin

Poster Details

First Author: M. Gessa SPAIN

Co Author(s):    C. Diaz-Ruiz   R. Angeles-Figueroa   I. Relimpio              

Abstract Details

Purpose:

To describe the clinical case of a patient with ligneous conjunctivitis due to plasminogen deficiency and the medical and surgical treatment, using dura mater and amniotic membrane to restore ocular surface and topical enhanced heparin hourly as a fibrinolytic

Setting:

Clinical and pathologyc study. Conjunctival biopsy, immune study and functional activity of plasminogen. Surgery in three times.

Methods:

Clinical case. Women, 46 years. Inactive thyroid orbithopathy with lower eyelid retraction. After surgery of scleral grafts in both lower eyelids the patient begins with membranous conjunctivitis. It is treated as a viral conjunctivitis, but 3 months later membranes persist. Immunological study was negative. Pathology of conjunctival lesion showed acute inflammation and abundant fibrin changes. Levels of plasminogen was decreased.Oral treatment: Azatyoprine and Prednisone. Topical: Ciclosporine 2% each 8h, Dexamethasone each 8h, Heparin 2600UI/mL every hour. Surgery to remove membranes and reconstruction of the tarsus with dura mater and amniotic membrane transplant is done, with cauterization of the blood vessels.

Results:

On the right eye membranes disappeared. On the left eye new membranes grew and currently there are being controlled by medical treatment, but there are not regress at all.

Conclusions:

When suspecting ligneous conjunctivitis, analysis should be performed to know plasminogen levels. Currently the treatment is based on Immunosuppressive and use of Heparin as a fibrinolytic. Caution in the removal of the membranes, the possible reactivation process.

Financial Disclosure:

NONE