Abstract
PURPOSE
To report the management of a case of corneal melting two weeks after pterygium excision with intraoperative topical mitomycin C (MMC).
RESULTS
A 57-year-old male was referred to our Department for therapy of rapidly progressive corneal melting two weeks after primary pterygium surgery with MMC (0.2 mg/ml) in September 2009. Initial treatment consisted of topical and systemic immunosuppression along with topical antibiotics. Eight days after presentation, the patient underwent successful lamellar keratoplasty and amnion membrane transplantation. Subconjunctival injection of triamcinolone (40 mg/ml) and topical bevacizumab were used to manage the increased fibrovascular activity around the site of the former pterygium.
CONCLUSION
Topical use of MMC during pterygium surgery may be related to serious postoperative complications such as progressive inflammatory corneal melting. The etiology may be multifactorial, which is related to MMC-induced inflammation and/or induced apoptosis. A therapeutic option is the described combination of systemic and local anti-inflammatory treatment along with lamellar keratoplasty and amniotic membrane transplantation. Adjunctive therapy may be needed if recurrence occurs.
TY - JOUR
T1 - Corneal melting two weeks after pterygium excision with topical mitomycin C: successfully treated with lamellar keratoplasty and amnion membrane transplantation.
AU - Menghini,Moreno,
AU - Watson,Stephanie L,
AU - Bosch,Martina M,
Y1 - 2012/01/31/
PY - 2012/5/23/entrez
PY - 2012/5/23/pubmed
PY - 2012/5/23/medline
KW - Amniotic membrane
KW - Corneal melting
KW - Lamellar keratoplasty
KW - Mitomycin C
KW - Pterygium
SP - 24
EP - 9
JF - Case reports in ophthalmology
JO - Case Rep Ophthalmol
VL - 3
IS - 1
N2 - PURPOSE: To report the management of a case of corneal melting two weeks after pterygium excision with intraoperative topical mitomycin C (MMC). METHODS: Case report. RESULTS: A 57-year-old male was referred to our Department for therapy of rapidly progressive corneal melting two weeks after primary pterygium surgery with MMC (0.2 mg/ml) in September 2009. Initial treatment consisted of topical and systemic immunosuppression along with topical antibiotics. Eight days after presentation, the patient underwent successful lamellar keratoplasty and amnion membrane transplantation. Subconjunctival injection of triamcinolone (40 mg/ml) and topical bevacizumab were used to manage the increased fibrovascular activity around the site of the former pterygium. CONCLUSION: Topical use of MMC during pterygium surgery may be related to serious postoperative complications such as progressive inflammatory corneal melting. The etiology may be multifactorial, which is related to MMC-induced inflammation and/or induced apoptosis. A therapeutic option is the described combination of systemic and local anti-inflammatory treatment along with lamellar keratoplasty and amniotic membrane transplantation. Adjunctive therapy may be needed if recurrence occurs.
SN - 1663-2699
UR - https://www.unboundmedicine.com/medline/citation/22615697/Corneal_melting_two_weeks_after_pterygium_excision_with_topical_mitomycin_C:_successfully_treated_with_lamellar_keratoplasty_and_amnion_membrane_transplantation
L2 - https://www.karger.com?DOI=10.1159/000336452
DB - PRIME
DP - Unbound Medicine
ER -