Treatment of Mooren’s ulcer coexisting with a pterygium using an intrastromal lenticule obtained from small-incision lenticule extraction: case report and literature review

Abstract

The coexistence of Mooren’s ulcer and a pterygium is an extremely rare ocular condition that has been infrequently reported in the literature to date. We herein present the first case of treatment of Mooren’s ulcer coexisting with a pterygium using a lenticule obtained by myopic small-incision lenticule extraction (SMILE). A 61-year-old woman presented with a 3-month history of recurrent ocular pain and red eye caused by Mooren’s ulcer coexisting with a pterygium. She received topical immunosuppressive and anti-infection treatments for almost 3 months. However, her ocular symptoms and signs did not substantially improve. Therefore, we performed lamellar keratoplasty with a corneal lenticule obtained by SMILE, followed by pterygium excision combined with conjunctival autografting. The patient recovered well with no complications or recurrence 1 year postoperatively. Our success suggests that combined surgery may be an effective management for coexistence of Mooren’s ulcer and a pterygium if conservative treatments fail. A corneal lenticule obtained by SMILE can be used as the lamellar keratoplasty graft in such patients.