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The management of conjunctival primary acquired melanosis (PAM) with atypia is in flux. Lesions are treated with biopsy, excision, adjunctive cryotherapy, or topical mitomycin.1 Acceptable, usually minimal, complications have been reported with these adjunctive therapies.2 Adverse events associated with topical mitomycin are uncommon and punctual stenosis is observed, especially in cold windy climates in approximately 20% of cases. Limbal stem cell deficiency has been described after the use of this agent on a dose-related basis, but is uncommon.2 3
We report a case of recurrent PAM with atypia treated with three courses of mitomycin and two courses of cryotherapy, with subsequent stem cell deficiency and vision …
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