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Lesions of the caruncle are uncommon. On account of the histological composition of the caruncle, which includes, in addition to conjunctiva, hair follicles, sebaceous glands, sweat glands, and accessory lacrimal tissue, the caruncle may develop lesions that may be similar to those found in the skin, conjunctiva, or lacrimal gland. Clinical preoperative diagnosis is very difficult and reached only in about half of the cases. The vast majority of lesions of the caruncle are benign, mainly nevi. Reported malignant lesions are very rare but can be potentially fatal. Although malignancy is clinically overestimated, any suspected malignant lesion should be excised and examined histopathologically by an experienced pathologist. This study presents the clinical and histological data of 42 consecutive caruncular lesions processed at our laboratory and reviews previously reported cases of caruncular lesions.

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Aim: To evaluate long term complications after pterygium excision with mitomycin C (MMC) application. Design: Prospective non-comparative interventional case series. Participants: Ninety nine patients who underwent pterygium surgery and participated in a controlled study for efficacy of MMC for pterygium surgery between 1989 and 1994. Methods: Patients who were located and agreed to come for examination underwent a complete eye examination. The bare sclera area, in particular, was examined for possible complications. The main outcome measures were anatomical findings in area of MMC application. Results: Forty three eyes of 43 patients were examined. Sixty three per cent of patients had pterygium surgery with intraoperative application of 0.02% MMC for 5 minutes and 37% of patients received MMC 1% or 2% drops four times daily for 2 weeks postoperatively. In three patients, pterygium recurred within 18 months. The only complication was mild conjunctival avascularity in areas of pterygium excision in 30% of patients. Conclusion: Long term evaluation revealed that the use of MMC in pterygium surgery is safe, but for a strict selection of patients, controlled use of MMC and long term follow up are required. P terygium is a common ocular surface disorder treated by surgical excision. Pterygia are more prevalent in patients living in regions closer to the equator.1 Histologically, an epithelial lining covers atrophic conjunctiva that extends beyond the limbus onto the cornea. Underneath this epithelium is a bulky mass of thickened, hypertrophic, and degenerated connective tissue characterised by elastoid degeneration.One of the major limitations of pterygium excision is the high rate of postoperative pterygium recurrence. The reported postoperative recurrence rate of pterygium excision alone ranges from 55.9% 2 to 89%. 3 In an effort to reduce the recurrence rate, adjunctive therapy such as beta irradiation, mitomycin C, 5-fluorouracil, and thiotepa have been used with varying success during the last three decades. [3][4][5][6][7][8][9][10][11][12] Mitomycin C (MMC) use, intraoperatively or postoperatively, is one of the adjunctive treatments that can significantly reduce the rate of pterygium recurrence.3-11 MMC is an antibiotic isolated from Streptomyces caespitosus. It is an alkylating agent that is bioreductive because it undergoes metabolic activation through a cytochrome P-450 reductase mediated reaction to create an alkylating agent. MMC damages cells by crosslinking DNA, forming covalent bonds with the guanine in DNA. MMC inhibits the synthesis of DNA, RNA, and protein and is radiomimetic in many of its actions. [13][14][15] Uncontrolled use or overdose of MMC may cause severe complications. In the ophthalmic literature, a variety of mild and severe complications were reported when pterygium excision was combined with topical MMC use. These complications occurred within the early postoperative period. Only two reports indicated long term complications related to MMC, after pterygium excision. 17 18 In our in...

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