Faculty Collaboration Database

Ocular surface squamous neoplasia after corneal graft. Am J Ophthalmol 2010 Jan;149(1):62-5

Date

10/23/2009

Pubmed ID

19846060

DOI

10.1016/j.ajo.2009.07.026

Scopus ID

2-s2.0-72049109697 (requires institutional sign-in at Scopus site)   20 Citations

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.

Author List

Ramasubramanian A, Shields CL, Sinha N, Shields JA

Author

Aparna Ramasubramanian MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Agents
Antineoplastic Combined Chemotherapy Protocols
Corneal Diseases
Corneal Transplantation
Eye Neoplasms
Female
Humans
Interferon-alpha
Male
Middle Aged
Mitomycin
Neoplasms, Squamous Cell
Photochemotherapy
Postoperative Complications
Recombinant Proteins
Retrospective Studies