The intraoperative use of mitomycin-C in excision of ocular surface neoplasia with or without limbal autograft transplantation.
OBJECTIVE
To evaluate the efficacy of intraoperative mitomycin-C in excision of ocular surface neoplasia for prevention of recurrence.


METHODS
Seven patients (eight eyes), three men and four women, aged 56 to 87 years (mean, 73.8 years), with lesions suspicious for corneal or conjunctival neoplasia, were operated on between October 1998 and March 2000. During excision of the lesion, mitomycin-C 0.02% was applied intraoperatively for 5 minutes. In two cases, excision was combined with conjunctival limbal autograft transplantation. All excised lesions were sent for histopathologic evaluation.


RESULTS
During the follow-up period ranging from 6 to 28 months (mean, 16 months) one patient (one eye) died of an unrelated cause. Histopathologic study showed four cases of squamous cell carcinoma, one case of carcinoma in situ, two cases of dysplasia, and one case of actinic keratosis. Of the eight eyes, no clinical recurrence of the lesion occurred in seven eyes, whereas one eye with squamous cell carcinoma showed mild recurrence 5 months after surgery and was successfully treated with topical mitomycin-C. Up to the last follow-up of this case 10 months later, the lesion did not recur.


CONCLUSIONS
The excision of conjunctival and corneal epithelial neoplasia combined with the intraoperative use of mitomycin-C seems to reduce the recurrence rate. The combined use of mitomycin-C and conjunctival limbal autograft transplantation in two cases did not alter the surgical outcome. More cases and a longer follow-up are needed to establish the efficacy of such an approach.
Siganos
Charalambos S
CS
Department of Ophthalmology, Herakl ion University Hospital, Crete, Greece.
Kozobolis
Vassilios P
VP
Christodoulakis
Emmanuel V
EV
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000601:surgery; D017690:Cell Transplantation; D003230:Conjunctival Neoplasms / Q000601:surgery*; D003316:Corneal Diseases / Q000188:drug therapy / Q000601:surgery*; D004847:Epithelial Cells / Q000637:transplantation*; D005134:Eye Neoplasms / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D014182:Transplantation, Autologous
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin