Anterior Segment Surgeries Under Topical Fresh Frozen Plasma Treatment in Ligneous Conjunctivitis

Abstract

Purpose: To evaluate the efficacy of topical fresh frozen plasma (FFP) therapy on clinical symptoms, findings, and prognosis after anterior segment surgeries in patients with ligneous conjunctivitis (LC). Methods: Retrospective case note review. Results: Eleven eyes of 7 cases whose remission was not achieved after medical treatment such as topical corticosteroids, cyclosporine A, and heparin were included in the study. The median age of admission was 19 (1–49) years, median duration of FFP treatment was 48 (15–79) months, median follow-up period was 62 (16–114) months, and median age at symptom onset was 12 (4–252) months. Diagnosis was made according to clinical presentations, plasminogen activities, and response to treatment. Topical FFP that was prepared in our clinic was used in all cases. Surgeries (membrane excision, eyelid surgery, deep anterior lamellar keratoplasty, and cataract surgery) were performed after at least 1 month of FFP treatment. Prosthetic contact lens was applied to one eye. During the follow-up period, recurrences requiring membrane excision and side effects from topical FFP were not observed. Conclusions: LC is a rare membranous conjunctivitis that proceeds with remissions and recurrences. When it was shown that the etiology of LC is plasminogen deficiency, FFP became the only treatment option targeting the etiology. In this study, we observed that the topical FFP is an effective treatment method that prevents recurrence and ensures regression of membranes and safer anterior segment surgeries in LC.

Ligneous conjunctivitis: Fresh-frozen plasma and heparin use intra-and postoperatively, a report of two cases

“…It usually occurs during infancy and childhood, with slight female predominance (2) . In addition, <20% occur in the fourth and fifth decades of life (4) . Disease onset is reported at a mean age of 13-16 years (2) .…”

“…So far, no consensus has been established on the best therapeutic approach. Some authors advocated topical fresh-frozen plasma (FFP) and heparin use, showing good initial results (4,5,7) .…”

Recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient: a case report

“…Ligneous conjunctivitis (LC) is a rare form of chronic conjunctivitis [ 1 ]. It usually occurs during infancy and childhood with a slight predominance in females whereas less than 20% occur in the fourth and fifth decade of life [ 1 , 2 ].…”

“…Ligneous conjunctivitis (LC) is a rare form of chronic conjunctivitis [ 1 ]. It usually occurs during infancy and childhood with a slight predominance in females whereas less than 20% occur in the fourth and fifth decade of life [ 1 , 2 ]. The first report of ligneous conjunctivitis in a 46-year-old man with bilateral pseudomembraneous conjunctivitis was published by Bouisson as early as 1847 [ 3 ].…”

“…The first report of ligneous conjunctivitis in a 46-year-old man with bilateral pseudomembraneous conjunctivitis was published by Bouisson as early as 1847 [ 3 ]. Overall, less than 200 cases have been reported in the literature up until 2021 [ 1 , 4 ].…”