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F. M. Dolan, E. Kemp; Topical Mitomycin C - An Effective Treatment for Ocular Surface Neoplasia. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5227.
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To determine the efficacy and side-effect profile of Mitomycin C 0.04% (MMC) as a treatment for ocular surface neoplasia.
A retrospective analysis of the case notes of 38 patients treated with MMC in the last 5 years was performed and the following information obtained: demographics of the patients; clinical and histopathological diagnosis of the lesions treated; dose and side-effects of MMC used and efficacy of treatment. MMC was prescribed four times a day for 3 weeks, then 3 weeks without MMC and then a further 3 weeks of MMC four times a day. Patients were also prescribed topical lubricants and steroids four times a day for 9 weeks.
Indications for MMC were: conjunctival melanoma, primary acquired melanosis (PAM), basal, squamous and sebaceous cell carcinoma, carcinoma in situ (CIN), papilloma involving punctum, naevi and pteryguim. MMC was prescribed as a primary treatment (34.2%), as a chemotherapeutic debulking agent (26.3%) and as an adjuvant post surgery (39.5%). Transient side-effects including hyperaemia (7.9%), epiphoria (10.5%), allergic conjunctivitis (7.9%), keratopathy (5.3%), dermatitis (2.6%) and iritis (5.3%) are described, however only 3 patients (8%) required cessation of treatment due to intolerant side-effects. A favourable outcome of tumour regression was obtained in 76.3% of patients.
MMC appears to be a useful and safe treatment for ocular surface neoplasia and if used with lubricant and steroid cover the side-effect profile is less than previously reported.
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