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

ABSTRACTWe 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.

摘要：本文报告1例合并角膜雾状混浊（corneal haze）的无异型增生原发性获得性角膜色素沉着症（primary acquired corneal melanosis without atypia）病例，患者既往有睑缘恶性黑色素瘤（limbal malignant melanoma）病史，并探讨丝裂霉素-C（mitomycin-C）对此类病症的治疗效果。该病例为一名75岁女性，既往有睑缘恶性黑色素瘤病史，因右眼视力下降就诊。角膜检查可见片状色素沉着伴中央区雾状混浊。局部应用丝裂霉素-C后，患者视力及角膜雾状混浊症状均得到改善，但色素性病灶仍持续存在，随后通过酒精角膜上皮切除术（alcohol corneal epitheliectomy）将其切除。组织病理学检查证实为无异型增生的原发性获得性角膜色素沉着症。病灶被成功切除，在36个月的随访周期内未出现复发。无异型增生的结膜与角膜色素沉着并存是一种罕见病症。此外，中央角膜雾状混浊与色素沉着共同存在可能会导致视力下降。局部应用丝裂霉素-C联合酒精角膜上皮切除术可作为此类病症的有效治疗手段。