ABSTRACT
PURPOSE: We report a case of successfully treating bilateral conjunctival-corneal intraepithelial neoplasia (CCIN) with surgical excision and adjunctive cryotherapy. CASE SUMMARY: A 74-year-old male visited our clinic for bilateral foreign body sensation and decreased visual acuity. His initial best corrected visual acuity was 20/50 in the right eye and 20/30 in the left eye. The right eye showed a 9 mm x 11 mm sized, gray-opaque limbal lesion from approximately the 7-o'clock position to the 11-o'clock position with spreading onto the cornea and conjunctiva. Biomicroscopy revealed a 6 mm x 7.5 mm sized minimally elevated, opaque lesion from the 3-o'clock to the 5-o'clock position extending to the central cornea in the left eye. The corneal lesion was well demarcated, opaque, and minimally elevated with bilateral focal pigmentation. Conjunctival lesions were finely vascularized and slightly elevated with melanocytic pigmentation. An excisional biopsy was performed to confirm the diagnosis and for therapeutic purposes, followed by an adjunctive cryotherapy. Postoperative corrected visual acuity improved up to 20/25 bilaterally and the patient had no recurrence 8 months after surgery. CONCLUSIONS: Bilateral conjunctival-corneal intraepithelial neoplasia is a rare condition. We report successful treatment and control of recurrence in a patient with bilateral conjunctival-corneal intraepithelial neoplasia using conventional surgical excision and adjuvant cryotherapy rather than topical chemotherapy.
Subject(s)
Humans , Male , Biopsy , Conjunctiva , Cornea , Cryotherapy , Eye , Foreign Bodies , Pigmentation , Recurrence , Sensation , Visual AcuityABSTRACT
PURPOSE: To evaluate the therapeutic effect of topical mitomycin C (MMC) on the diffuse conjunctival-corneal intraepithelial neoplasia (CCIN). METHODS: Three patients histopathologically confirmed the conjunctival-corneal intraepithelial neoplasia (CCIN) received topical drop of 0.04% MMC four times daily for 2 to 4 weeks. Ocular complications and recurrence were evaluated under slit lamp biomicroscope. RESULTS: One case received topical drop of 0.04% MMC four times daily for 2 weeks and two cases of CCIN received for 4 weeks in the same manner. These lesions were completely regressed and did not recur under slit lamp biomicroscope during the follow-up of 18 months, 6 months, and 5 months, respectively. Other complications except superficial punctate keratitis and conjunctival injection did not develope and visual acuities have been improved. CONCLUSIONS: It appears that the application of topical MMC alone could be a primary effective treatment for diffuse conjunctival-corneal intraepithelial neoplasia (CCIN).
Subject(s)
Humans , Follow-Up Studies , Keratitis , Mitomycin , Recurrence , Visual AcuityABSTRACT
PURPOSE: To investigate the effect of topical Mitomycin C(MMC) as a medical adjunct to incompletely excised conjunctival-corneal intraepithelial neoplasia(CCIN) for removal of remaining neoplastic cells and prevention of recurrence. METHODS: The authors applied postoperative topical 0.02% MMC adjunctively on 2 eyes of 2 patients with incompletely excised and histopathologically confirmed conjunctival-corneal intraepithelial neoplasia(CCIN) for 2weeks and if the lesion is not regressed, topical MMC treatment with the same regimen was added. RESULTS: Remaining lesions were completely regressed and no recurrence has been found with follow up to 25 months and 26 months in each case. CONCLUSIONS: Topical MMC chemotherapy would be an effective treatment modality on incompletely excised conjunctival-corneal intraepithelial neoplasia(CCIN) for removal of remaining neoplatic cells and prevention of recurrence.