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Mitomycin C-associated scleral stromalysis after pterygium surgery
T Peter Lindquist1, W Barry Lee
1Division of Ophthalmology, Piedmont Hospital; Cornea Service, Eye Consultants of Atlanta, Atlanta, GA.
Cornea
|February 27, 2015
Summary
Mitomycin C (MMC) used in pterygium surgery can lead to severe scleral stromalysis, a complication appearing months to years later. Extreme caution and long-term patient follow-up are crucial due to potential anterior segment issues.
Area of Science:
- Ophthalmology
- Surgical Complications
- Ocular Oncology
Background:
- Pterygium surgery aims to remove abnormal conjunctival growth.
- Mitomycin C (MMC) is sometimes used as a surgical adjuvant to prevent recurrence.
- Adverse effects of MMC, though rare, necessitate careful consideration.
Purpose of the Study:
- To describe complications, specifically scleral stromalysis, following the use of mitomycin C (MMC) as a surgical adjuvant in pterygium surgery.
- To highlight the delayed onset and severity of these complications.
Main Methods:
- Retrospective chart review of patients diagnosed with scleral stromalysis after pterygium surgery with adjuvant MMC.
- Analysis of patient data from a tertiary referral center over a 7-year period.
- Inclusion criteria focused on cases with documented MMC use and subsequent scleral stromalysis.
Main Results:
- Sixteen eyes of 15 patients presented with scleral stromalysis post-MMC adjuvant therapy for pterygium.
- Complications ranged from 1 month to 10 years after initial surgery.
- 31% of patients required scleral patch grafts, with 8% needing multiple grafts.
Conclusions:
- Mitomycin C, in various forms and concentrations, can cause severe complications like scleral stromalysis.
- Scleral stromalysis can manifest significantly later than the initial surgery.
- Emphasizes the need for extreme caution with MMC in pterygium surgery and the importance of long-term patient monitoring for anterior segment complications.
