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P.L. Ballalai, C. Erwenne, M. Rigueiro, M. Lowen, M.C. Martins; Topical Mitomycin C (MMC) 0.02% in the Treatment of Corneal – Conjunctival Intraepithelial Neoplasia (CCIN): Long–Term Results . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4692.
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To evaluate the efficacy and the long–term effects on the ocular surface with the use of topical MMC 0.02% in the treatment of CCIN.
Patients with clinical and cytological diagnosis of CCIN were included. They were divided into two groups: Group 1: primary lesions; Group 2: recurrent lesions. MMC 0.02% qid for 28 days was given to all patients. Ophthalmologic exams were performed weekly during the use of the medication, monthly during the first three months, every three months during the next two years, and every six months thereafter. Effectiveness of the treatment and side effects was recorded.All patients signed an informed consent and this study was approved by the Ethic committee of this Institution.
Fourteen patients were enrolled, 9 in Group 1 and 5 in Group 2. Six were males and eight females. All of them were white. The mean age was 61, 7 years old (range 38 to 81 you).The inclusion criteria was: neoplastic cells suggesting CCIN at the pathology (biopsy or cytology). The exclusion criteria were presence of dry eye or corneal /scleral thinning, associated diseases (HIV infection, xeroderma pigmentosus)or inability to come to the medical visits. All patients were treated with MMC 0,02% qid for four weeks. During the treatment the main ocular sintoms and signs were redness, tearing, foreign body sensation and pain, which mostly occurred after the second week of treatment. Control cytology was negative for neoplastic cells in all patients one month after the end of the treatment. During the follow up 3 patients had arecurrence of the lesion (Group 1: 1 patient and Group 2: 2 patients). They occurred after three months in two patients (one of Group 1, and one of Group 2), and after 24 months in one patient (group 2). Corneal epithelial defect was the only long term side effect observed in both groups: Group 1 : 1 patient; Group 2: 2 patients. It occurred in a mean of 16.6 months (range, 12 – 24 months).
All patients were followed at least for 12 months, and the mean follow up of both groups was 42.2 months (range, 12 to 64 mo.).Two patients on Group 1 were lost of follow up because they died of unrelated causes.
Topical MMC 0.02% is effective in the treatment of primary and recurrent CCIN. Patients with recurrent lesions are at higher risk of developing recurrences, as well as developing long term complications such epithelial defects after the treatment..
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