Corneal melanosis successfully treated using topical mitomycin-C and alcohol corneal epitheliectomy: a 3-year follow-up case report

Abstract

We report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.

Corneal dysplastic melanosis associated with recurrent corneal erosions

“…[1] Melanocytic proliferations in corneal tissue were reported occasionally, mostly in patients with prior history of trauma or conjunctival PAM or malignant melanoma. [2–4] However, to our knowledge, there has been no report as to a corneal epithelial barrier dysfunction accompanied by corneal PAM. This is the 1st case report of corneal PAM which led to recurrent corneal erosions.…”

Effectiveness of Topical Chemotherapy in Pigmented and Scamous Lesions of the Ocular Surface: Literature Review

“…Side effects of local chemotherapy generally resolve after treatment interruption, being a good alternative to surgical excision and cryotherapy in treatment of nevi with atypia, PAM with atypia and even melanoma [50][51][52]. Treatment with topical MMC not only reduces the size and degree of clinical pigmentation lesions, in conjunctiva and lesions involving corneal epithelium, but also eradicates residual atypical conjunctival melanocytes [53,54].…”