Ocular surface squamous neoplasia after corneal graft.

Abstract:

PURPOSE:To describe the clinical features and management of ocular surface squamous neoplasia (OSSN) after corneal graft. DESIGN:Retrospective case series of 4 patients. METHODS:Four eyes of 4 patients treated for OSSN after corneal graft in an institutional setting were included. All 4 patients were treated with topical chemotherapy and additionally 1 patient each was treated with excisional biopsy and photodynamic therapy. The main outcome measure was the recurrence of OSSN and the clarity of corneal graft after treatment. RESULTS:The mean time interval between corneal graft and diagnosis of OSSN was 36 months (range, 2 to 73 months). All 4 eyes were on chronic treatment with topical steroids for a minimum duration of 2 months and 2 eyes had previous herpes keratitis. Misdiagnosis of graft rejection was found in 2 cases. The mean tumor basal diameter was 18 mm (range, 14- to 25-mm) and the tumor involved a mean of 76% of the corneal surface (range, 15% to 90%). Management was successful in all cases using topical mitomycin C (n = 1), topical interferon alpha2b (n = 4), and photodynamic therapy (n = 1). At mean follow-up of 20 months, tumor control was achieved in all cases and all 4 eyes showed chronic graft opacification with vascularization but no intraocular tumor. CONCLUSION:Corneal OSSN should be considered in patients using chronic topical steroids for corneal graft. Nonsurgical management with topical chemotherapy or photodynamic therapy can achieve tumor control.

journal_name

Am J Ophthalmol

authors

Ramasubramanian A,Shields CL,Sinha N,Shields JA

doi

10.1016/j.ajo.2009.07.026

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

62-5

issue

1

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(09)00538-8

journal_volume

149

pub_type

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