Risk factors for recurrence of Mooren's ulcer after keratoplasty

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: 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.