Successful Treatment of Bilateral Conjunctival-Corneal Intraepithelial Neoplasia: Case Report and Review of the Literature

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.