A Comparative Evaluation of the Efficacy of Intraoperative Mitomycin C Use after the Excision of Cobblestone-Like Papillae in Severe Atopic and Vernal Keratoconjunctivitis

Mari Tanaka, Yoji Takano, Murat Dogru, Kazumi Fukagawa, Naoko Asano-Kato, Kazuo Tsubota, Hiroshi Fujishima

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: To evaluate the effect of intraoperative 0.02% mitomycin-C (MMC) use after excision of cobblestone-like papillae on preventing corneal recurrences compared with simple papillary resection. Methods: Thirteen cases of atopic keratoconjunctivitis (AKC) and 6 cases of vernal keratoconjunctivitis (VKC) with a mean age of 12.0 ± 3.4 years participated in this study. All patients had cobblestone-like papillae on the upper tarsal conjunctiva and corneal ulcers or erosions that were refractory to conventional treatment. Seventeen eyes received simple papillary excision. Papillary excision with intraoperative application of MMC was performed in 7 eyes: 0.02% MMC was applied for 2 minutes to the upper palpebral conjunctiva immediately after papillary excision, Recurrence of corneal lesions and regrowth of papillae were evaluated and compared retrospectively between the 2 groups. Postoperative follow-up ranged from 12 to 18 months. Results: Papillary regrowth was observed in 14 out of 17 eyes (82.4%) in the simple resection group, whereas regrowth was noted in 4 out of 7 eyes (57.1%) in the MMC group (P > 0.05). The recurrence of corneal lesions was observed in 8 out of 17 eyes (47.1%) in the simple resection group (mean onset 1.5 ± 1.7 months) compared with 1 eye with corneal recurrence 6 months after surgery in the MMC group (14.3%). The difference was statistically significant (P < 0.05). No complications related to MMC use were observed during the follow-up period. Conclusion: MMC-aided papillary resection may be rewarding in well-selected severe AKC and VKC cases in preventing recurrence of corneal complications, but the potential complications of MMC use would suggest caution in its consideration.

Original languageEnglish
Pages (from-to)326-329
Number of pages4
JournalCornea
Volume23
Issue number4
DOIs
Publication statusPublished - 2004 May 1
Externally publishedYes

Keywords

  • Atopic keratoconjunctivitis
  • Corneal ulcer
  • Mitomycin C
  • Papillae
  • Vernal keratoconjunctivitis

ASJC Scopus subject areas

  • Ophthalmology

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