Topical Mitomycin-C for Treatment of Partially-Excised Ocular Surface Squamous Neoplasia

Background: This study was conducted to determine the treatment outcome of incompletely removed, histopathologically documented ocular surface squamous neoplasia with mitomycin-C. Methods: Through an interventional case series, 17 eyes of 17 patients presented with incompletely removed ocular surface squamous neoplasia were treated according to a protocol using two to three alternate seven-day courses of 0.04% mitomycin-C. Clinical recurrence was retreated with the same protocol. All patients had weekly follow-up visits to the end of the treatment course, then biweekly visits for three months, and monthly visits, thereafter. Results: The mean±SD follow-up period was 30.76±4.4 (range: 24.5 – 41) months. Five patients (29.4%) experienced recurrence after the initial treatment; four of them responded to retreatment and were disease-free till the end of follow-up. Survival analysis with Kaplan-Meier method was performed. Taking into account four recurrences, the 41-month nonrecurrence rate was 70.6%. However, including four of five patients with recurrence who responded to retreatment, the final outcome in survival analysis was 94.1% nonrecurrence for 41 months of follow-up. All patients reported mild to moderate redness and irritation which were controlled with lubricants and mild corticosteroid eye drops. No serious ocular or systemic side effects were observed. Conclusion: Point zero four percent (0.04%) mitomycin-C drop used as two to three alternate seven-day courses seems to be a safe and effective treatment for ocular surface squamous neoplasia.