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Luana Campos, Leonardo Pinheiro Teixeira, Mayara Martins Abrahao, Belquiz A Nassaralla, Arthur Nassaralla; TITLE: Excision, Cryotherapy, and Postoperative Mitomycin C for the Treatment of Conjunctival-corneal Intraepithelial Neoplasia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3497.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the safety, efficacy and incidence of recurrence of the lesion using three different techniques for the treatment of Conjunctival-corneal intraepithelial neoplasia.
Twenty-six eyes of 26 patients, 11 women and 15 men were included in a nonrandomized, retrospective, observational case series. Mean patient age was 64 years (range, 32-88 years). All patients were treated at the Goiania Eye Institute from 1999 to 2014. Mean postoperative follow-up was 4 years (range, 3 months to 14 years). All patients underwent excision of the lesion with a 4-mm safety margin and a 2-mm from the limbus cryotherapy. As further treatment the patients were divided into three groups: Group 1 (8 eyes) - conjunctival autograft and 2 cycles of mitomycin C 0.02% (MMC) eye drops, four times daily for 10 days with an interval of 30 days between cycles. Group 2 (9 eyes) - amniotic membrane (AM) graft and 3 cycles of MMC eye drops, three times daily for 10 days with an interval of 10 days between the 1st and 2nd cycle and 30 days between the 2nd and 3rd cycle. Group 3 (9 eyes) - AM graft without MMC eye drops.
After a single treatment, the lesions were eradicated in twenty-three patients. Recurrence was noted in three patients from Group 3 at 3 months, 6 months and 1 year after treatment. Two of them were retreated by the technique used in Group 1 without further recurrence; the other patient underwent enucleation. No adverse effects related to the use of mitomycin C were observed during re-epithelialization or during follow up.
Mitomycin C 0.02% proved to be safe and effective for the treatment of primary and recurrent conjunctival-corneal intraepithelial neoplasia. Both the amniotic membrane and conjunctival grafts were effective to cover the bare scleral area. Further studies are needed to identify the optimal dosage and concentration of MMC for the treatment of these lesions.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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