title: Surgical versus medical treatment of ocular surface squamous neoplasia: a comparison of recurrences and complications.
abstract: OBJECTIVE
  Treatment for ocular surface squamous neoplasia (OSSN) has historically been surgery, but nonsurgical interventions are increasingly used. Treatment with interferon is efficacious, but evidence is needed regarding recurrence and complication rates in comparison with surgery. The objective of this study is to compare the recurrence and complication rates of surgical treatment and interferon treatment for OSSN.
  
  
  METHODS
  A matched, case-control study.
  
  
  METHODS
  Ninety-eight patients with OSSN, 49 of whom were treated with interferon (IFN) α2b therapy and 49 of whom were treated with surgical intervention.
  
  
  METHODS
  Patients with OSSN were treated with surgery versus IFNα2b therapy, either in topical or injection form. Median follow-up after lesion resolution was 21 months (range, 0-173 months) for the IFNα2b group and 24 months (range, 0.9-108 months) for the surgery group.
  
  
  METHODS
  The primary outcome measure for the study was the rate of recurrence of OSSN in each of the treatment groups. Recurrence rates were evaluated using Kaplan-Meier survival analysis.
  
  
  RESULTS
  Mean patient age and sex were similar between the groups. There was a trend toward higher clinical American Joint Committee on Cancer tumor grade in the IFNα2b group. Despite this, the number of recurrences was equal at 3 per group. The 1-year recurrence rate was 5% in the surgery group versus 3% in the IFNα2b group (P = 0.80). There was no statistically significant difference in the recurrence rate between the surgically and medically treated groups. Nonlimbal location was a risk factor for recurrence (hazard ratio, 8.96) in the entire study population. In patients who were treated successfully, the side effects of the 2 treatments were similar, with mild discomfort seen in the majority of patients in both groups. There was no limbal stem cell deficiency, symblepharon, or diplopia noted in either group. Two patients were excluded from the IFNα2b group because of intolerance to the medication.
  
  
  CONCLUSIONS
  No difference in the recurrence rate of OSSN was found between surgical versus IFNα2b therapy.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: Afshan A
authors.initials: AA
authors.lastname: Nanji
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: Christina S
authors.initials: CS
authors.lastname: Moon
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: Julia
authors.initials: J
authors.lastname: Sein
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
authors.forename: Patrick
authors.initials: P
authors.lastname: Oellers
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida. Electronic address: ckarp@med.miami.edu.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Karp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; 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*; D016022:Case-Control Studies; D003230:Conjunctival Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003316:Corneal Diseases / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017679:Cryotherapy; D005134:Eye Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D011994:Recombinant Proteins / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009883:Ophthalmic Solutions; D011994:Recombinant Proteins