MITOMYCIN-C TREATMENT FOR CONJUNCTIVAL-CORNEAL INTRAEPITHELIAL NEOPLASIA - A MULTICENTER EXPERIENCE

Objective: The purpose of the study is to evaluate the efficacy and ri sks of topical mitomycin C (MMC) for conjunctival-corneal intraepithel ial neoplasia (CCIN). Design: The study design was a clinical case ser es of CCIN. Participants: Seventeen patients, 16 with biopsy-confirme d CCIN and 1 with invasive squamous cell carcinoma (SCC), were include d in the study. Intervention: Patients received topical drops of MMC 0 .02% to 0.04% four times daily from 7 to 28 days. Retreatment was done in cases of lesion recurrence. Main Outcome Measures: The size of the CCIN before and after the treatment and ocular complications post-MMC application were evaluated. Results: Ten patients remained disease-fr ee after one course of MMC application. In one case, residual CCIN rem ained very small without regrowth. In the one patient with invasive SC C and in five patients with CCIN, regrowth occurred within 6 months of the first treatment. After retreatment, invasive SCC and CCIN in an a dditional two patients were eradicated. In two cases, although the siz e of the lesions decreased after two and three applications of MMC, re growth occurred, and the CCIN returned to its original size. In the fi nal case, limited recurrence has occurred and no retreatment has been done. The complications of MMC use included mild-to-moderate conjuncti val hyperemia and mild allergy, which resolved after discontinuation o f the treatment. Severe pain manifested when treatment was longer than 14 days. Conclusions: Application of topical MMC is an efficient trea tment for most but not all cases of CCIN.