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Conjunctival Flap Surgery for Calcified Scleromalacia After Cosmetic Conjunctivectomy

Kwon, Hee J MD; Nam, Sang M. MD; Lee, Sang Y. MD; Ahn, Ji M. MD; Seo, Kyoung Y. MD, PhD

doi: 10.1097/ICO.0b013e318277ac92
Clinical Science

Purpose: To investigate the long-term clinical course of scleromalacia with calcified plaque as a complication of cosmetic conjunctivectomy with topical mitomycin C (MMC) application and to introduce a surgical method for this complication using calcified plaque removal and/or conjunctival flap surgery.

Methods: Eleven patients (15 eyes, 17 lesions) were included in this retrospective study. The calcified plaque was removed with forceps and pterygium knife, and the thinned scleral lesion was covered with a conjunctival flap from an intact superior or inferior conjunctiva.

Results: There were no cases of scleral thinning or calcified plaque recurrence in patients who underwent conjunctival flap surgery. The mean interval between previous cosmetic conjunctivectomy with postsurgical topical MMC and the first surgical treatment for complications was 20.0 ± 6.4 months. The mean postoperative follow-up duration after last conjunctival flap surgery or calcified plaque removal was 11.6 ± 4.0 months.

Conclusions: Scleral calcification and thinning progress as time passes after cosmetic conjunctivectomy with postsurgical topical MMC. Calcified plaque removal with conjunctival flap surgery can be an effective surgical management for this complication, returning blood supply to a thinned sclera.

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*Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Gyeonggi, Korea

Department of Ophthalmology, Siloam Eye Hospital, Seoul, Korea.

Reprints: Kyoung Y. Seo, Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea (e-mail:

Supported by a grant (A103001) of the Korea Healthcare Technology R&D Project‚ Ministry of Health and Welfare‚ Korea.

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received May 07, 2012

Accepted October 04, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.