J Korean Ophthalmol Soc.  2020 Oct;61(10):1221-1224. 10.3341/jkos.2020.61.10.1221.

Conjunctival Fibroma after Excision of a Recurrent Pterygium

• Yoon JS
• Ko BY

• KMID: 2511255
• DOI: http://doi.org/10.3341/jkos.2020.61.10.1221

Abstract

Purpose
To report a case of conjunctival fibroma after excision of a recurrent pterygium.
Case summary
A 44-year-old male was referred with pterygium recurrence. The patient had undergone pterygium surgery on his left eye 7 years prior. Examination of the conjunctiva revealed fibrovascular proliferative tissue that had grown onto the cornea at the medial limbus in his left eye. The patient underwent pterygium excision, amniotic membrane transplantation, and intraoperative 0.02% mitomycin C soaking. Pterygium was confirmed histologically. Two years after surgery, a 5 × 3 mm semi-translucent, white conjunctival mass at the medial limbus was found in the left eye. The best-corrected visual acuity was 1.0 in both eyes and the intraocular pressure was within normal limits. Suspecting recurrent pterygium, the patient underwent excision of the conjunctival mass, conjunctival autograft, and 0.02% mitomycin C soaking during surgery. Under histologic examination, paucicellular substantia propria with abundant collagen and scattered fibroblasts was observed; the mass was diagnosed as conjunctival fibroma. No sign of recurrence was evident 2 years postoperatively.
Conclusions
Although conjunctival mass after pterygium excision is likely to be recurrent pterygium in most cases, there is the rare possibility of conjunctival fibroma; thus, histologic examination should be performed for differential diagnosis.

Keyword

Conjunctiva; Fibroma; Pterygium