Regional conjunctivectomy with postoperative mitomycin C to treat chronic hyperemic conjunctiva

To introduce a new surgical technique to treat persistent irreversible hyperemic conjunctiva and evaluate the clinical results.

A total of 571 patients with chronic conjunctival injection refractory to medical treatment were included. During surgery of the medial bulbar area, the conjunctiva and Tenon capsule were excised from the limbus to near the plica semilunaris. The lateral conjunctiva and Tenon capsule were removed from the limbus to beside the lateral canthus. Mitomycin C 0.02% was applied 4 times daily for 2 to 5 days postoperatively. The complications and surgical results of regional conjunctivectomy were evaluated.

A total of 1815 ocular regions of 571 patients underwent regional conjunctivectomy. The mean period of conjunctival injection was 9.9 ± 6.9 years. The patients were followed for 2 to 27 months (average, 12.9 months). The overall postoperative satisfaction rate was 94.6%; 328 regions (18.1%) underwent surgical revision for growth of fibrovascular scar tissue. No serious complications developed intraoperatively. Postoperative complications included intraocular pressure elevations (98 of 571; 17.2%), development of granuloma (153 of 1815; 8.4%), transient subjective visual decreases (43 of 571; 7.5%), pigment deposition (96 of 1815; 5.3%), scleral calcification (70 of 1815; 3.9%), and diplopia because of adhesion esotropia (9 of 571; 1.6%). All complications were managed surgically and/or medically. No permanent deficits resulted.

Regional conjunctivectomy with postoperative mitomycin C 0.02% can be useful to successfully treat patients with chronic hyperemic conjunctivae refractory to medical treatment.