Beyond The Ocular Surface: Severe Retinal Necrosis After Pterygium Surgery Due To Presumed Suprachoroidal Mitomycin-C Migration
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR100 | Type: Case Report | DOI: 10.82333/nt56-1w38
Authors: Dr Mireia Minguell Barbero* 1 , Dr Maria Júlia Martínez Malizia 2 , Dr Miriam Barbany Rodríguez 2 , Dr Irene Sassot Cladera 2 , Dr Carolina Rius Tornés 2 , Dr Ángela Serrano Membrive 2 , Dr Paula Rivero Frisch 2 , Dr Mei Martínez Alegre 2 , Dr Daniel García Ordoñez 2
1Ophthalmology,Hospital Universitari Mútua Terrassa,Terrassa,Spain;Ophthalmology,Hospital Universitari Mútua Terrassa,Terrassa,Spain, 2Ophthalmology,Hospital Universitari Mútua Terrassa,Terrassa,Spain
Purpose
To describe a rare posterior segment complication of pterygium surgery, likely caused by suprachoroidal migration of mitomycin-C (MMC), resulting in severe retinal toxicity and necrosis.
Setting
Department of Ophthalmology, Mútua Terrassa University Hospital, Terrassa, Barcelona, Spain
Report of case
A 46-year-old female had a history of prior pterygium surgery in both eyes. She subsequently underwent excision of a recurrent temporal pterygium with amniotic membrane graft in the left eye (LE), with topical mitomycin-C 0.02% application for 1 minute. Preoperatively, best-corrected visual acuity (BCVA) was 1.0 in the LE. At 1.5 months postoperatively, BCVA decreased to hand motion. Intraocular pressure remained normal. Fundus examination revealed papillary pallor and retinal atrophy involving the macula, inferior, and nasal retina, with extensive retinal whitening. Optical coherence tomography of the macula confirmed atrophy. Fluorescein angiography demonstrated early perfusion alterations in the affected inferior-nasal area with window defects, variable vessel filling, and late leakage; the peripheral retina was normal, with no macular edema, papillitis, vasculitis, or other inflammatory signs. Laboratory tests, chest imaging, and evaluation for uveitis were unremarkable. Findings were consistent with toxic retinal injury, likely due to suprachoroidal migration of MMC.
Conclusion/Take home message
This case highlights a rare but severe retinal complication of pterygium surgery, emphasizing the need for vigilance during intraoperative use of mitomycin-C.