Treatment of peripheral corneal ulcers by limlial conjunctivectomy

We report the rapid healing of several cases of marginal corneal ulceration of various aetiologies after the excision of a 4 to 7 mm strip of adjacent limbal conjunctiva. After conjunctivectomy the remaining conjunctiva was loosely recessed (without sutures). In one case with coexisting scleromalacia, we excised strips of adjacent bulbar conjunctiva with equally good results. Some of the cases had failed to respond to other modes of treatment including topical collagenase inhibitors. One case responded to peritomy and cryotherapy to the ulcer edges, but we have abandoned this treatment in favour of conjunctival excision. Limbal conjunctivectomy with recession is presumed to act by eliminating conjunctival sources of collagenase and proteoglycanase.