Abstract
Purpose :
To present a case of delayed scleromalacia one year after conjunctival melanoma excision with mitomycin-C (MMC) therapy and double freeze-thaw technique.
Methods :
Case report
Results :
A 69-year-old lady had a conjunctival melanoma excised by the ‘no touch technique’ with intraoperative MMC, freeze-thaw cryotherapy and amniotic membrane transplant elsewhere. Three months later she presented to our ophthalmology unit with a red, sore and painful right eye. Examination revealed severe scleritis. She was treated with lubricants and oral steroids for six weeks. She settled well with no recurrence of melanoma. At one year she developed scleromalacia and conjunctival blebs in the inferonasal quadrant of the right eye.
Conclusions :
Severe caution should be exercised with the use of intraoperative MMC during excision and cryotherapy of conjunctival melanoma. When using MMC, it would be recommended to use the lowest dose topically in the form of eye drops postoperatively for the shortest time, to avoid any sight-threatening complications. Our case, was a rare example that scleral thinning can occur post scleral dissection and MMC use for an ocular surface neoplasia.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.