Fungal Sclero-keratitis Following Pterygium Excision With Mitomycin Application – A Case Report

1. Jnanankar Medhi¹
2. Prafulla Sarma¹
3. Kalyan Das¹
4. Balmukund Agarwal¹
5. Harsha Bhattacharjee¹

1. Sri Sankaradeva Nethralaya, Guwahati, India

Purpose: The use of Mitomycin C in pterygium surgery may present with serious post-operative complications like scleral melting. The authors report a case of severe fungal sclero-keratitis with scleral melting in the right eye in a patient who had undergone pterygium excision with mitomycin application in the same eye two months back.

Methods: The reports describe the step wise approach of a case of severe sclero-corneal melting complicated with corneal perforation and superadded fungal infection. The author describe the preparation of the scleral bed with antifungals for subsequent scleral patch graft surgeries and highlights the difficulties in surgical management of a post-mitomycin scleral melt due to altered sclero-conjunctival anatomy.

Results: The ocular integrity could be well restored with multiple surgeries with restoration of vision of finger counting at one meter.

Conclusion: Large post-mitomycin scleral melts can be well managed with planned surgeries and adjuvant conservative measures.