Limbal stem cell deficiency after subconjunctival mitomycin C injection for trabeculectomy.

Purpose: To report on severe limbus cell insufficiency after trabeculectomy with subconjunctival injection of mitomycin C.

Design: Interventional small case-series.

Methods: Seven consecutive Caucasian patients (seven eyes) underwent penetrating trabeculectomy that included subconjunctival injection of 0.1 to 0.2 ml of mitomycin C (0.2 mg/ml) at the 12 o'clock position.

Results: All patients with a follow-up time of >1.5 years (n = 3 eyes; 43%) experienced marked ocular surface problems that included corneal thinning (n = 1) and scleral melting (n = 2). Four patients (57%) with a follow-up time of <14 months did not show complications that were attributable to the subconjunctival application of mitomycin.

Conclusions: Because limbal stem cell deficiency may be a late complication of subconjunctival mitomycin C injection, subconjunctival injection of mitomycin C may be avoided in routine antiglaucomatous filtering surgery.