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Adjuvant 5-fluorouracil in the treatment of localised ocular surface squamous neoplasia
  1. Adam K Rudkin1,
  2. James S Muecke1,2
  1. 1South Australian Institute of Ophthalmology, Adelaide, South Australia, Australia
  2. 2Discipline of Ophthalmology & Visual Sciences, University of Adelaide, South Australia, Australia
  1. Correspondence to Dr Adam K Rudkin, South Australian Institute of Ophthalmology, c/o Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia; rudkin.adam{at}


Aim To report the outcome of treatment of localised non-invasive ocular surface squamous neoplasia (OSSN) where topical 5-fluorouracil (5-FU 1%) is used as an adjuvant to surgical excision.

Methods The study was a prospective non-comparative interventional case series. 55 cases of primary localised OSSN and 10 cases of recurrent localised OSSN were treated with excision, cryotherapy and adjuvant 5-FU 1%. In all cases, irrespective of the involvement of surgical margins, a single cycle of 5-FU 1% was administered, four times a day for 2 weeks continuously. The main outcome measures were (1) recurrence and (2) complications related to adjuvant topical chemotherapy. Individuals were reviewed for a minimum of 12 months.

Results There was a single case of recurrence (1.5%). 57% of patients had short-term complications secondary to 5-FU 1%, most frequently lid toxicity (49%), followed by superficial keratitis, epiphora and corneal epithelial defects. Four patients were unable to complete the course of 5-FU 1% because of local toxicity.

Conclusions The management of localised non-invasive OSSN with adjuvant 5-FU 1% was associated with a low rate of local recurrence. Although 5-FU 1% frequently results in short-term complications, most commonly lid toxicity, a full course is usually tolerated. Serious complications appear uncommon in the treatment of localised disease.

  • conjunctival neoplasms [C04.588.364.235]
  • neoplasms
  • squamous cell [C04.557.470.700]
  • antineoplastic agents [D27.505.954.248]
  • ocular surface squamous neoplasia (non-MeSH)
  • 5-fluorouracil (non-MeSH)
  • conjunctiva
  • cornea
  • neoplasia
  • treatment surgery

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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