TOPICAL HEPARIN IN THE TREATMENT OF LIGNEOUS CONJUNCTIVITIS

Background: Ligneous conjunctivitis is a rare acute or subacute membra nous conjunctivitis of unknown etiology for which no generally accepte d form of treatment is available. Methods: Between 1972 and 1993, 17 p atients with ligneous conjunctivitis were treated with excision biopsy , meticulous hemostasis, and immediate, intensive topical treatment wi th heparin, steroids, and, in 12 patients, alpha-chymotrypsin until al l signs of conjunctival inflammation had subsided. Results: On histolo gic examination, the lesions consisted of subepithelial deposits of fi brin in all patients. Eight patients had no recurrence (mean follow-up , 33.1 months), and in four patients the conjunctivitis was controlled after one repeat excision and topical treatment (mean follow-up, 40.3 months). One patient had three recurrences before responding to treat ment (follow-up, 24 months). In four patients, treatment was unsuccess ful, although lesion-free intervals were longer than usually seen in t his condition (mean, 7.8 months). Conclusion: These results suggest th at intensive and early use of topical heparin may improve therapy resu lts in ligneous conjunctivitis.