Topical Mitomycin C for Partially Excised Ocular Surface Squamous Neoplasia

Purpose: To develop a guideline for the treatment of incompletely removed histopathologically documented ocular surface neoplasia (OSSN) with mitomycin C (MMC). Materials Methods: Through an interventional case series, 17 eyes of 17 patients presented with incompletely removed OSSN were treated according to a protocol using 2-3 alternate 7-day courses of MMC 0.04%. Clinical recurrence was re-treated with the same protocol. All patients had weekly follow up visits to the end of treatment course, then biweekly visits for 3 months, and monthly visits thereafter. Results: Four patients (23.5%) experienced recurrence after the initial treatment, 3 of them responded to re-treatment and were disease-free till the end of follow up. All patients reported mild to moderate redness and irritation which was controlled with lubricants and mild corticosteroid eye drops. No serious ocular or systemic side effects were observed. Conclusion: MMC drop 0.04% used as 2-3 alternate seven-day courses is a safe and effective treatment for OSSN. Attempting more than 2 courses of treatment (up to 4) in the initial regimen may result in lower recurrence rates.