Intraepithelial and invasive squamous cell carcinoma of the conjunctiva: analysis of 60 cases

Aim-To evaluate the clinical features, treatment results, and recurrence ra tes in patients with either intraepithelial or invasive squamous cell carci noma of the conjunctiva. Methods-Retrospective analysis of 60 cases (22 conjunctival intraepithelial and 38 invasive squamous cell carcinomas) to determine patterns of clinica l presentation, aetiological factors, and treatment results. The mean patie nt age was 64 years old. 70% of the patients were male. Patients were treat ed with a variety of therapies, depending on the degree of tumour involveme nt; most cases were treated with frozen section controlled excision and adj unctive cryotherapy. Modified eye wall resection or enucleation was done fo r intraocular invasion and exenteration was done for orbital involvement. Results-Red eye (68%) and ocular irritation (57%) were the most common pres enting symptoms. 44% of the patients had other eye findings consistent with extensive solar exposure. 20% of the patients had a history of malignant s kin tumours. Visceral malignancies developed in 8%. Scleral involvement was present in 14 (37%), intraocular involvement in five (13%), and orbital in vasion in four (11%) cases with invasive squamous cell carcinoma. After a m ean follow up of 56 months (18-226 months) the rate of new or recurrent tum ours was 4.5% for intraepithelial squamous carcinoma and 5.3% for invasive squamous cell carcinoma. No patient developed metastases or tumour related deaths. Conclusion-Excision with intraoperative control of the surgical margins and adjunctive cryotherapy results in good tumour control rates.