Figure 1.

An example of MMC toxicity that successfully resolved with the treatment. A 54-year-old female suffering from biopsy-proven enlarging PAM with moderate atypia in the left eye, which had already been treated with surgical excision and conjunctival graft 8 years earlier for localized PAM with severe atypia. Part (A): Slit lamp picture at baseline, with tumour recurrence surrounding the paralimbal scar of the previous surgery. Part (B): Complete disappearance of pigmented cells 2 years after four courses of MMC 0.02% (one drop QID for 7 days). Part (C): Allergic reaction to MMC starting from the second cycle of treatment, presenting with lid edema, conjunctival swelling, epiphora, and photophobia. Part (D): Fluorescein staining revealed a peripheral superficial corneal epithelial defect. The allergic reaction has been managed with cold compresses, artificial tears, vitamin A ointment, and suspension of MMC. Once the epithelium was completely healed, MMC has been started again in association with weak steroid eye drops and close surveillance.