11 September 2013
Posted in Pearls in Ophthalmology
By Brooke Strickland
In this cross-sectional cohort study, researchers sought to measure what complications arose after patients underwent cosmetic wide conjunctivectomy with mitomycin C application with or without bevacizumab injection. For the study, researchers examined medical records of 1,713 patients in a 2.5 year period (November 2007 to May 2010) who had cosmetic wide conjunctivectomy plus postoperative topical mitomycin C either with or without a bevacizumab injection. Records were used from patients who had the surgery done at the same office by the same surgeon. Researchers communicated with 557 of the patients via telephone and interviewed them, then followed them for an average of 10.9 months. The goal was to measure complications, recurrences, and overall patient satisfaction.
Results showed that patients had the surgery to treat conjunctival hyperemia. Medical records indicated that 8.8% were diagnosed with hyperemia, 14% had pterygium, 3.5% had dry eye, 1.5% had pinguecula, and 23.3% had a conjunctival disorder. The diagnoses for the other 48.9% of the patients were not mentioned, or the patients chose to have the procedure for cosmetic reasons. The overall complication rate was 82.9%, of which 55.6% were considered severe (fibrovascular conjunctival tissue proliferation, 43.8%; scleral thinning, 4.4%; scleral thinning with calcified plaques, 6.2%; intraocular pressure elevation, 13.1%; diplopia, 3.6%; and recurrence of hyperemic conjunctiva, 28.1%). (1)
What to take away from the study: The cosmetic wide conjunctivectomy with postoperative mitomycin C with or without bevacizumab injection has significant risks, including severe complications and risk of reoperation.
1. Lee, Seonheui, Go, Jeongae, Rhiu, Soolienah, Stulting, R. Doyle, Lee, Min, Jang, Sunyoung, Lee, Sangmoo, Kim, Hyung Joon, Chung, Eui Sang, Kim, Sooyoung, Seo, Kyoung Yul. “Cosmetic Regional Conjunctivectomy with Postoperative Mitomycin C Application With or Without Bevacizumab Injection.” American Journal of Ophthalmology. Volume 156, Issue 3, Pages 616-622.e3, September 2013. Accessed September 8, 2013. http://www.ajo.com/article/S0002-9394%2813%2900108-6/abstract