Author(s): Russell HC, Chadha V, Lockington D, Kemp EG
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Abstract INTRODUCTION: The use of topical mitomycin C (MMC) has gained popularity in the management of ocular surface neoplasia. The aim of this study is to determine outcomes and complications following such treatment. METHODS: This study is a retrospective review of patients treated with topical MMC for ocular surface neoplasia, including primary acquired melanosis (PAM), melanoma, corneal-conjunctival intraepithelial neoplasia (CCIN), squamous cell carcinoma (SCC) and sebaceous gland carcinoma (SGC). Data regarding diagnosis, short- and long-term outcomes, and short- and long-term complications, were recorded. RESULTS: 58 patients were identified, with a mean age of 63 years and mean follow-up of 36 months. 21 received MMC as primary therapy and 37 as surgical adjuvant. The regimen was 0.04\% MMC four times a day for 3 weeks on, 3 weeks off, 3 weeks on, with topical steroid and lubricants throughout. Initial clinical response was either partial or complete in 93\%. Overall, 26\% developed recurrent disease at a mean of 13 months post treatment. Recurrence rates by pathology were 20\% PAM, 25\% melanoma, 0\% CCIN, 67\% SCC and 57\% SGC. Short-term complications occurred in 52\%, but only 7\% required treatment cessation. Long-term complications such as persisting keratoconjunctivitis, epiphora and corneal problems, occurred in 31\%. CONCLUSION: The results confirm the effectiveness of topical MMC chemotherapy in the management of ocular surface neoplasia. Self-limiting short-term complications were common; however, limbal stem cell deficiency appears to be a significant long-term complication of treatment, occurring in 12\%.
This article was published in Br J Ophthalmol
and referenced in Journal of Clinical & Experimental Ophthalmology