Surgical Outcome of Chemical Peeling of Conjunctival Nevus with Alcohol

PURPOSE: To evaluate the efficacy of chemical peeling using 83% alcohol in patients with conjunctival nevus. METHODS: Chemical peeling using 83% alcohol was performed in 13 patients (13 eyes) who were clinically diagnosed with benign conjunctival nevus. Effects of procedure and recurrence were analyzed by retrospectively reviewing medical records. After topical anesthesia, conjunctival nevus was eliminated by rubbing with an alcohol-soaked cotton ball. Conjunctival nevus close to corneal limbus was removed by 15th blades of scalpel. RESULTS: A total of 13 patients, 8 males, and 5 females had a, mean age of 27 years (12-54 years). Eights of the eyes were right eyes, and 5 were left eyes. No recurrence was detected in any patient during the follow-up period (mean 54 months), and there were no cases of conjunctival scar, granuloma, or permanent conjunctival injection. All patients were satisfied with the cosmetic outcome of chemical peeling. CONCLUSIONS: Chemical peeling using alcohol for conjunctival nevus is a non-invasive technique and has benefits such as no intraoperative hemorrhage, low recurrence rate, easy method, and good cosmetic results. Based on these, this procedure is a good method for eliminating conjunctival nevus.

Concordancia de la citología de impresión y la patología con nevus conjuntivales en la Clínica Oftalmológica de Cartagena / Concordance between impression cytology and pathology evaluation in patients with conjunctival nevus at Clínica Oftalmológica de Cartagena

Objetivos: evaluar la concordancia entre la citología de impresión y el estudio de anatomía patológica en pacientes con nevus conjuntivales que consultaron al Departamento de Córnea de la Clínica Oftalmológica de Cartagena. Diseño del estudio: estudio de concordancia. Métodos: se tomaron 48 ojos de 44 pacientes con hiper o hipopigmentación conjuntival a los que se le realizó citología de impresión y estudio histopatológico comparándose los resultados. Resultados: durante Junio 2011 a Junio 2012 se incluyeron 48 pacientes con sospecha de nevus conjuntivales a los cuales se les realizó citología de impresión y estudio histopatológico. Tuvo más prevalencia el sexo femenino con 68.75%. La edad promedio fué de 34.5 años. Las lesiones encontradas en OD fueron el 52.08%. El 60.42% presentaron pigmento leve o moderado seguido de un 35.42% de pacientes con abundante pigmentación. La localización más común de la lesión fue la conjuntiva bulbar con 93.75%. La citología de impresión resultó positiva para nevus en el 89.58% mientras que la patología arrojó resultados de nevus sub-epitelial en un 35.42%, seguido de nevus compuesto y de unión en el 33.33 y 20.83% respectivamente, y ausencia de nevus en el 10.42%. La sensibilidad de la citología de impresión fue de 93.02% con una especificidad del 40%. Conclusiones: la citología de impresión es un método altamente sensible para la detección de nevus conjuntivales y puede ser utilizado como prueba de tamizaje.

Objectives: to evaluate the concordancebetween impression cytology and pathology evaluation in patients with conjunctival nevus attending Cornea Clinic at Clinica Oftalmológica de Cartagena. Study Design: concordance study Methods: We evaluated 48 eyes from 44 patients with conjunctival hyper or hypopigmentation whom underwent impression cytology and histopathology assessment to find concordance between two methods. Results: during June 2011 to June 2012, we included 48 patients with suspected conjunctival nevus whom underwent impression cytology and histopathology study. Female prevalence was 68.75%. Average age was 34.5 years. Lesions were found in right eye in 52.08% of patients. 60.42% had moderate or mild pigment followed by 35.42% with abundant pigment. The most common location of injury was the bulbar conjunctiva with 93.75%. Impression cytology was positive for nevus in 89.58%, while pathology studies showed subepithelial nevus in 35.42% of cases, followed by compound nevus and union nevus with 33.33% and 20.83% respectively. 10.42% of patients showed absence of nevus. Sensitivity of impression cytology was 93.02% while specificity of the test achieved 40%. Conclusions: impression cytology is a highly sensitive method to detect conjunctival nevi and can be used as a screening test.

A Case of Giant Conjunctival Nevus Mimicking Malignant Melanoma

PURPOSE: We report a case of giant conjunctival nevus and compare differential diagnosis between giant conjunctival nevus and conjunctival malignant melanoma. CASE SUMMARY: A 46-year-old male presented with brown and elevated conjunctival mass in his right eye since childhood. The mass was located at the superior bulbar conjunctiva involving the superior cornea. The mass was 16 x 9 mm in size and elevated. Feeding vessels, intrinsic vessels and various cyst sizes were observed inside the mass. Resection of the conjunctival mass and amniotic membrane transplantation were performed. The histopathological diagnosis was conjunctival nevus. CONCLUSIONS: Conjunctival nevus is a benign conjunctival tumor with excellent prognosis, often confused with conjunctival melanoma. Both conjunctival nevus and conjunctival malignant melanoma are commonly located in the bulbar conjunctiva, pigmented and often have feeder and intrinsic vessels. Conjunctival nevus has an intralesional cyst, which is a key differentiating characteristic from malignant melanoma as many other features overlap. The change in tumor size, increased pigmentation and corneal invasion are features suspect of malignant transformation and surgical excision and histologic examination are recommended for those lesions. Surgical excision for giant conjunctival nevus can cause several ocular complications such as symblepharon. Conjunctival reconstruction with amniotic membrane transplantation is useful for preventing complications.

Argon Laser Ablation of Conjunctival Nevus

PURPOSE: To evaluate the efficacy of argon laser in the ablation of benign conjunctival pigmented nevi. METHODS: We conducted a prospective, observational case study, on a series of argon laser ablations of conjunctival pigmented nevi, in 30 eyes of 28 patients. Laser ablation was applied directly to the conjunctival pigmented nevus in all patients. The mean age of the patients was 33.0 +/- 9.3 years old, and the male to female ratio was 3: 25. All patients were followed up over a period of at least 6 months. RESULTS: The mean size of the conjunctival lesions was 3.9 X 2.8 mm. In all patients, the conjunctival lesions to which the argon laser was applied disappeared almost completely within two days after treatment. No lesion recurrence was detected in any patient during the follow-up period, nor were there any conjunctival scars or conjunctival injection. All patients were satisfied with the results of the procedure. CONCLUSIONS: Argon laser ablation of conjunctival pigmented nevi resulted in uniformly excellent clinical outcomes. Therefore, this study concludes that argon laser ablation is a safe and effective modality for the treatment of benign conjunctival nevi, and that this method is capable of replacing the classical surgical procedure.

Treatment of Conjunctival Nevus with Argon Laser

PURPOSE: To evaluate the clinical efficacy of Argon laser photocoagulation in patients with conjunctival nevus. METHODS: Twenty-seven patients (27 eyes) who were clinically diagnosed with conjunctival nevus from January to September 2003 were included in this study. The conjunctival nevus was eliminated by Argon laser after topical anesthesia with proparacaine. The power density varied between 200 and 400 mW and the spot size ranged from 100 to 300 microgram. The duration of argon laser was 0.15~0.2 sec. The spot count was varied according to the size and degree of pigment density of conjunctival nevus. The mean follow-up period was 7.0 months. RESULTS: The wounds after Argon laser treatment were completely healed within 1 week. Twenty-three eyes were treated completely with only one laser treatment but 4 needed an additional laser treatment for more satisfactory cosmetic results. There were no postoperative complications such as infections, conjunctival degeneration or recurrence. CONCLUSIONS: Argon laser treatment for conjunctival nevus has benefits such as no intraoperative hemorrhage, low recurrence rate, easier method and good cosmetic results.