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MMC use during pterygium surgery may cause scleral stromalysis
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The use of mitomycin C as an adjuvant in pterygium surgery may cause severe complications in the short or long term postoperatively, according to a study.
The retrospective chart review evaluated 13 eyes that presented with a diagnosis of scleral stromalysis after pterygium removal with the use of adjuvant MMC. The time from pterygium surgery to presentation of scleral stromalysis ranged from 1 month to 10 years postoperatively.
Patients were treated with varying dosages and routes of administration of MMC using multiple surgical techniques. MMC was applied to bare sclera in five eyes and Tenon’s capsule in three eyes, with application ranging from 30 seconds to 3 minutes. One patient received MMC topically four times daily for 2 weeks postoperatively.
After presentation of scleral stromalysis, eight eyes were treated with observation and/or ocular surface lubrication alone, four eyes were treated with scleral patch graft, and one eye was treated with an amniotic membrane graft.
“Because a safe and seemingly equally effective alternative exists, that of conjunctival autograft, we recommend that MMC be used with extreme caution in the setting of primary pterygium removal,” the study authors said. - by Kristie L. Kahl
Disclosure: The authors report no relevant financial disclosures.
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