Recurrence of Ocular Surface Squamous Neoplasia Treated With Excisional Biopsy and Cryotherapy.
OBJECTIVE
To evaluate the recurrence rate of ocular surface squamous neoplasias (OSSN) after excision and cryotherapy in an academic cornea practice and to determine factors associated with recurrence.


METHODS
Retrospective interventional case series.


METHODS
All cases of OSSN from 1998 through 2013 that were treated with excisional biopsy and adjunctive cryotherapy were retrospectively reviewed. Clinical characteristics upon presentation including size of lesion, location, and atypical features were noted. All recurrences of OSSN after excision and cryotherapy were noted and categorized in relation to clinical characteristics, pathologic grade, and margin involvement.


RESULTS
Forty-three cases of OSSN from 42 patients were analyzed with a median follow-up of 29 months. A total of 32.6% of subjects had dysplasia and 67.4% had squamous cell carcinoma (SCC). A total of 83.7% of subjects had both corneal and conjunctival involvement while 16.3% had conjunctival involvement only. Overall, 3 recurrences were observed, all of which had margin involvement; nonetheless, the majority of incompletely excised OSSN (25/28) showed no recurrence. The recurrence rate at 6 months was 2.3%. Recurrence at 1 year, 2 years, and 5 years remained stable at 7.1%.


CONCLUSIONS
Excision with cryotherapy is an effective treatment for the majority of OSSN cases, even among cases with pathologic evidence of tumor at the margin, with an overall recurrence rate of 7.1% at 1 year, 2 years, and 5 years.
Department of Ophthalmology, North Shore Long Island Jewish Health System, Great Neck, New York. Electronic address: AlbertLiMD@gmail.com.
Albert S
AS
Li
Department of Ophthalmology, North Shore Long Island Jewish Health System, Great Neck, New York.
Carolyn Y
CY
Shih
Feinstein Institute for Medical Research, Biostatistics Unit, North Shore Long Island Jewish Health System, Manhasset, New York.
Lisa
L
Rosen
Department of Ophthalmology, North Shore Long Island Jewish Health System, Great Neck, New York.
Anne
A
Steiner
New York Eye and Ear Infirmary, New York, New York.
Tatyana
T
Milman
Department of Ophthalmology, North Shore Long Island Jewish Health System, Great Neck, New York.
Ira J
IJ
Udell
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D003230:Conjunctival Neoplasms / Q000175:diagnosis / Q000601:surgery; D003316:Corneal Diseases / Q000175:diagnosis / Q000601:surgery; D003452:Cryosurgery / Q000379:methods*; D005134:Eye Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome