To determine the risk factors of corneal ulcers that require eyeball removal even when properly managed.

We performed a retrospective review of 30 patients (30 eyes) who were diagnosed with corneal ulcers and underwent eyeball removal, even though their cases were properly managed, between 1990 and July, 2005. The Patients included of 14 males and 16 females. The mean age of the patients was 61.6±12.2. The ages of 20 patients were between 60 and 79.

Unknown (13/30 [43.4%]) was the most commonly identified predisposing factor. The other predisposing gactors were ocular trauma (10/30 [33.3%]); bullous keratopathy (3/30 [10%]); keratoplasty (1/30 [3.3%]); pterygium excision (1/30 [3.3%]); history of Mooren's ulcer (1/30 [3.3%]); and bee sting (1/30 [3.3%]). The visual acuity at the time of evisceration was LP (-) (14/30 [46.7%]); LP (+) (4/30 [13.3%]); and hand motion (12/30 [40%]). Organisms were cultured in 7 patient (23.3%). Among these patients, funguses were cultured in 4 patients, and bacteria were cultured in 3 patients. The most common causes of evisceration were perforation (13/30 [43.3%]); pain (7/30 [23.3%]); impending perforation (7/30 [23.3%]); phthisis bulbi (1/30 [3.3%]); and endophthalmitis (1/30 [3.3%]).

According to this study, old age, ocular surface and other ocular disease and the corneal ulcer caused by fungi are the risk factor that can lead to a condition that requires removal of the eyeball. Consequently, we should pay special attention to patients who have these risk factors.