Risk factors for recurrence of Mooren's ulcer after keratoplasty

The purpose of this study was to investigate the clinical characteristics of patients with corneal Mooren's ulcers (MU) and explore potential risk factors for recurrence after keratoplasty.

The study retrospectively analyzed 87 patients (101 eyes) diagnosed with MU. Factors associated with recurrence after keratoplasty were identified using correlation analysis, and a clinical scoring system was developed based on the magnitude of the univariate and multivariate logistic regression analysis.

The average age of onset for the 87 patients was 55.2 years old, and the male-to-female ratio was 1:0.74. Of the 101 eyes diagnosed with MU, 73 cases (83.9 %) were Unilateral. Eleven eyes (10.9 %) had a history of ocular surgery, and five (5.0 %) had a history of ocular trauma. The perforation rate was 18.8 %, and the recurrence rate after keratoplasty was 37.3 %. Ulcer depth (P < 0.05, R = -0.252), corneal perforation status (P < 0.05, R = 0.238), and history of ocular surgery or trauma (P < 0.05, R = -0.238) were associated with recurrence. Based on these findings, a clinical scoring system was constructed to evaluate the recurrence of MU.

MU mostly occurs in elderly men, often with monocular onset. The recurrence rate after keratoplasty is high at 37.3 %. Deep ulcer infiltration, corneal perforation, and a history of ocular surgery or trauma are associated with recurrence after keratoplasty. A scoring system has been established based on these clinical characteristics and can be used to predict the risk of recurrence after keratoplasty.