Elsevier

Ophthalmology

Volume 115, Issue 8, August 2008, Pages 1297-1302.e1
Ophthalmology

Original article
Topical Interferon or Surgical Excision for the Management of Primary Ocular Surface Squamous Neoplasia

https://doi.org/10.1016/j.ophtha.2008.01.006Get rights and content

Objective

To describe the successful treatment and long-term outcomes of primary ocular surface squamous neoplasia (OSSN) with topical interferon alfa-2b or surgical excision.

Design

Retrospective, comparative, interventional case series.

Participants

Twenty-nine consecutive patients with OSSN never before treated.

Intervention

Patients with primary OSSN chose topical interferon alfa-2b or excision with wide surgical margins, with crossover to surgery in those interferon-treated patients whose OSSN failed to regress within 2 months after beginning therapy.

Main Outcome Measures

Successful resolution of clinical disease at 2 months after topical interferon treatment and time to recurrence after either topical interferon or surgical excision.

Results

Of 29 patients with primary OSSN, 15 elected topical interferon and 14 chose surgical excision. Two patients in the interferon group subsequently underwent surgical excision for apparent lack of response to interferon. No patient in either group developed a recurrence during the study period (disease-free follow-up: interferon group, mean, 35.6 months [95% confidence interval, 21.9–49.3]; surgery group, mean, 35.6 months [22.9–48.3]).

Conclusions

Both topical interferon alfa-2b and aggressive surgical excision appear to be effective for primary OSSN.

Section snippets

Materials and Methods

We performed a retrospective chart review of consecutive patients with primary OSSN (never before treated) presenting to the Dean McGee Eye Institute between January 1, 1996 and December 31, 2005. Institutional review board approval was obtained from the University of Oklahoma Health Sciences Center before initiation of the review. The initial diagnosis of OSSN was based on the ocular surface appearance at slit-lamp examination.4, 60 Patients diagnosed with primary OSSN chose either surgical

Results

Twenty-nine patients presenting between January 1, 1996 and December 31, 2005 were diagnosed with OSSN based on characteristic findings on slit-lamp examination—each patient had a raised epithelial lesion centered at the limbus with a leukoplakic, gelatinous, or papilliform appearance.4, 60 Of patients with primary OSSN, 15 elected to receive topical interferon alfa-2b and 14 elected to undergo excisional biopsy. Representative slit-lamp photographs before and after treatment are presented in

Discussion

Successful use of topical interferon alfa-2b as sole therapy for primary OSSN was previously reported in 15 patients in 5 previously published series (Table 3),50, 51, 52, 55, 58 with only 1 patient observed for more than 16 months.51 Our 13 patients successfully treated with topical interferon alfa-2b for primary OSSN bring the total number of patients in the published literature with primary OSSN successfully treated with topical interferon alfa-2b to 28, with a median disease-free follow-up

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    Manuscript no. 2007-1314.

    Supported by a Physician–Scientist Merit Award (JC) and an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York, to the Department of Ophthalmology, University of Oklahoma.

    The authors have no conflict of interest in the material presented in the article.

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