Korean J Ophthalmol.  2013 Jun;27(3):208-210. 10.3341/kjo.2013.27.3.208.

The Development of Scleromalacia after Regional Conjunctivectomy with the Postoperative Application of Mitomycin C as an Adjuvant Therapy

• Shin HY
• Kim MS
• Chung SK

• KMID: 1798060
• DOI: http://doi.org/10.3341/kjo.2013.27.3.208

Abstract

A 40-year-old woman presented with ocular discomfort in both eyes that had persisted for several months. Six months ago, she had undergone a bilateral nasal and temporal conjunctivectomy using a bare scleral technique followed by a postoperative application of 0.02% mitomycin C (MMC) to treat her chronic hyperemic conjunctiva for cosmesis. Slit-lamp examination revealed that the patient had bilateral nasal and temporal scleral thinning, and a calcified plaque on her nasal conjunctiva. There was no episcleral tissue present around the wound area, and it was difficult to detect any normal conjunctival tissue in the adjacent area for covering the lesion. We believe that performing an aggressive conjunctival excision procedure followed with MMC application for cosmetic enhancement may be disastrous in certain cases.

Keyword

Mitomycin C; Regional conjunctivectomy; Scleromalacia

MeSH Terms

Adult
Antibiotics, Antineoplastic/adverse effects
Conjunctival Diseases/*drug therapy/pathology/*surgery
Female
Humans
Mitomycin/*adverse effects
Postoperative Complications/*chemically induced/pathology
Scleral Diseases/*chemically induced/pathology
Antibiotics, Antineoplastic
Mitomycin

Figure

• 

  Fig. 1 Slit-lamp photographs of both eyes show a broad area of diffuse thinning, centered on the surface of the operated bare sclera, surrounded by edematous conjunctiva (arrow head) (A, right eye; F, left eye). Yellowish-white calcified plaques were noted on the nasal bulbar conjunctiva (arrow) (B, right eye; G, left eye). The thinned bare scleral area was covered with a thin membranous tissue after the previous surgery. No fluorescence stained lesion was detected on her left eye (C, right eye; H, left eye). Nine weeks later, fluorescence stained lesions had developed on the calcified plaque of the nasal bulbar conjunctiva (D, right eye; I, left eye). Fifteen months later, the thinned scleral area and fluorescence stained lesions showed no significant interval change (E, right eye; J, left eye).

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