Topical mitomycin C chemotherapy for conjunctival melanoma and PAM with atypia
- aThe Ocular Tumour Service, The New York Eye and Ear Infirmary, New York City, bDivision of Ocular Tumour and Orbital Disease, North Shore University Hospital, New York University School of Medicine, Manhasset, New York, cDepartment of Ophthalmology, Saint Savas Hospital of Athens, Athens, Greece
- Paul T Finger, MD, Ocular Tumour Service, New York Eye and Ear Hospital, 310 East 14th Street, New York City, NY 10003, USA.
- Accepted 11 November 1997
Abstract
AIM To evaluate topical mitomycin C (MMC) chemotherapy in the treatment of conjunctival melanoma and primary acquired melanosis with atypia.
METHODS In a phase I clinical trial, 10 patients with conjunctival melanoma and/or primary acquired melanosis with atypia were treated with topical MMC 0.04% four times daily. Four patients were given MMC for 28 days as a primary treatment. Six patients were treated with MMC for 7 days after excision and cryotherapy in an effort to improve local control. In this series, 10 patients have been followed for an average of 29 months.
RESULTS All patients were noted to develop transient keratoconjunctivitis during treatment. One patient also developed a transient corneal epithelial defect. Decreased conjunctival pigmentation was noted in the four patients where topical chemotherapy was used as a primary treatment. Nodular tumours were resistant to topical MMC chemotherapy. Of the six patients treated within 2 weeks after primary excision and cryotherapy, there has been no tumour recurrence or symblepharon formation. Nine of the 10 study patients have maintained within one line of their pretreatment visual acuity. No retinal or optic nerve toxicity was noted.
CONCLUSION Since no complications which might preclude further investigation of topical MMC chemotherapy occurred, it was concluded that topical MMC chemotherapy was tolerated as a treatment for conjunctival melanoma and primary acquired melanosis with atypia.
