Abstract

P 243

Corneal ulcers in the context of chronic Dacryocystitis

Mueller S., Emmerich K. H.
Eyehospital, Klinikum Darmstadt

Objective: On the basis of 3 casuistics the pathology, the progression and the necessary therapy of corneal ulcers in the context of chronic Dacryocystitis is demonstrated.
Methods: All 3 cases present at the first consultation in our ambulance recidivating erosion of the cornea and corneal ulcers with resistance of therapy. In addition to the corneal pathology, the cases presents the clinical picture of a chronic Dacryoystitis. The irrigation shows a total obstruction with purulent reflux. The echography of the lacrimal system present in all cases a mucocele in the range of the lacrimal sac. The smear of the conjunctiva and the cornea identify several bacterial pathogens, in one case with multiple resistances. In all cases we performed a dacryocystorhinostomia externa.
Results: Postoperatively the corneal ulcer completely diasappeared in all cases. 3 months after the operation the patients have no disorders and the visual acuity increased.
Conclusions: In case of persistent corneal ulcers lacrimal obstruction with chronic appearance of microbes in the conjunctival sac should be considered. In case of coexisting lacrimal system obstructions persistent corneal ulcers may only be cured successful surgery of the lacrimal system.

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