Management of intraepithelial and invasive neoplasia of the cornea and conjunctiva: a long-term follow up.
OBJECTIVE
The aim of this work is to report the long-term results of using immunotherapy for the management of cornea and conjunctiva intraepithelial neoplasia and squamous cell carcinoma after surgical excision of the neoplasm.


METHODS
Ten eyes of 10 patients with cornea and conjunctiva intraepithelial neoplasia or squamous cell carcinoma had wide surgical excisions of the neoplasm after evaluation of the level of corneal involvement using ultrasound biomicroscopy. All eyes received topical cyclosporine A (0.05%) and topical mitomycin C (0.01%) 4 times daily for 12 weeks after surgery. All eyes were followed up every month for 6 months and then every 6 months for another 18 months.


RESULTS
All eyes showed total cure with no recurrence during the 2-year follow-up period. Epithelial toxicity (punctate keratopathy) occurred in 3 eyes, ocular irritation and mild conjunctival hyperemia in 5 eyes, and lid toxicity in 2 cases during the treatment with mitomycin C. There were no serious complications that necessitated stopping the treatment.


CONCLUSIONS
During a 2-year follow-up period, the use of topical cyclosporine A (0.05%) combined with mitomycin C (0.01%) as an adjunctive treatment after surgical excision in cornea and conjunctiva intraepithelial neoplasia and squamous cell carcinoma was found to prevent tumor recurrence, especially in extensive lesions, when surgical excision cannot ensure a tumor-free margin.
Zaki
Ahmed A
AA
Cornea and Ocular Surface Unit, Department of Ophthalmology, Research Institute of Ophthalmology, Giza, Egypt. ahmedazaki@hotmail.com
Farid
Samar F
SF
D000368:Aged; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003230:Conjunctival Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003316:Corneal Diseases / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016572:Cyclosporine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005134:Eye Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D009361:Neoplasm Invasiveness; D013508:Ophthalmologic Surgical Procedures; D016896:Treatment Outcome
D016685:Mitomycin; D016572:Cyclosporine