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Complications of cosmetic wide conjunctivectomy combined with postsurgical mitomycin C application.

 Rhiu, Soolienah  ;  Shim, Jongwoo  ;  Kim, Eung Kweon  ;  Chung, Sung Kun  ;  Lee, Jong Soo  ;  Lee, Jong Bok  ;  Seo, Kyoung Yul 
 CORNEA, Vol.31(3) : 245-252, 2012 
Journal Title
Issue Date
Adult ; Astringents/administration & dosage* ; Conjunctiva/drug effects* ; Conjunctiva/surgery* ; Conjunctival Diseases/drug therapy* ; Conjunctival Diseases/surgery* ; Female ; Humans ; Male ; Middle Aged ; Mitomycin/administration & dosage* ; Ophthalmologic Surgical Procedures/adverse effects* ; Postoperative Complications* ; Retrospective Studies ; Visual Acuity
cosmetic wide conjunctivectomy ; mitomycin C ; avas-cular sclera ; restrictive strabismus
PURPOSE: To raise awareness among clinicians about the risk of severe complications after cosmetic conjunctivectomy plus postsurgical topical mitomycin C (MMC) treatment. METHODS: We retrospectively reviewed the medical records of 48 consecutive patients who received cosmetic wide conjunctivectomy plus postsurgical topical MMC treatment to eliminate conjunctival injection and visited our outpatient clinic between January 2009 and January 2011. RESULTS: Forty-four patients (91.67%) developed complications after cosmetic wide conjunctivectomy plus postsurgical topical MMC treatment. Complications included chronic conjunctival epithelial defects (22 patients), scleral thinning with (19 patients) or without (2 patients) calcified plaques, fibrovascular conjunctival adhesion at the muscle insertion site (15 patients), chronic dysfunctional tear syndrome (11 patients), avascular zones (10 patients), abnormal vessel growth (5 patients), lymphangiectasis (3 patients), adhesions of Tenon capsule and the conjunctiva at the extraocular muscle insertion site (1 patient), extraocular muscle fiber exposure (1 patient), and diplopia (9 patients). The mean time between surgery and the onset of diplopia was 1.67 months (range, 1-3 months), and the mean deviation was 11.0 prism diopters (range, 0-25 prism diopters) in the primary position. Three patients underwent strabismus surgery due to incomitant esotropia. Eight patients underwent calcified plaque removal because of severe progression of the calcification. Five patients underwent conjunctival flap operation because of severe progressive scleral thinning. CONCLUSIONS: Cosmetic wide conjunctivectomy, which has been advertised as a simple and effective surgical option for the treatment of conjunctival injection, has caused disruption in the normal physiology of the ocular surface, which leads to various devastating complications.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Rhiu, Soolienah(유수리나)
Lee, Jong Bok(이종복)
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