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E. S. Birkholz, K. M. Goins, A. S. Kitzmann, J. E. Sutphin, Jr., M. D. Wagoner; Treatment of Ocular Surface Squamous Cell Intraepithelial Neoplasia With and Without Mitomycin C. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2992.
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To analyze the outcome of excisional biopsy of ocular surface (conjunctival and corneal) squamous cell intraepithelial (in situ) neoplasia with and without the use of intraoperative and postoperative adjunctive mitomycin C.
Retrospective review of thirty four eyes of thirty four consecutive patients with histopathologically-proven ocular surface intraepithelial neoplasia that was treated between January 1, 1980 and December 31, 2008 at the University of Iowa Hospitals and Clinics. Eyes in which at least 3 months of follow-up available were included in the statistical analysis.
Thirty-two eyes met the inclusion criteria. Adjunctive therapy was provided with mitomycin C in 17 eyes, including 13 that only had postoperative treatment and 4 that only had intraoperative treatment. The use of adjunctive mitomycin C was associated with a significantly reduced prevalence of recurrence (5.9% vs. 66.7%, P = 0.0005). When the surgical margins were positive, the use of adjunctive mitomycin C was associated with a reduced prevalence of tumor recurrence (12.5% vs. 55.6%), but this difference was not statistically significant (P = 0.13). When surgical margins were negative, the use of adjunctive mitomycin C was significantly associated with a reduced prevalence of recurrence (0% vs. 83.3%; P = 0.002).
The use of adjunctive mitomycin C is significantly associated with a reduction in the prevalence of postoperative recurrences of ocular surface squamous cell intraepithelial neoplasia, regardless of the status of the surgical margins. The use of postoperative mitomycin C should be considered even when surgical margins are negative.
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