Role of mitomycin C in the management of ocular surface squamous neoplasia

Background: Ocular surface squamous neoplasia (OSSN) in a broader terminology recently introduced in the field of ophthalmology that includes conjunctival malignancies which ranges from mild epithelial dysplasia to invasive squamous cell carcinoma. The routinely used topical chemotherapy for OSSN is mitomycin C (MMC), 5-fluorouracil, interferon-alpha, and cidofovir, and among these, MMC is usually preferred by most of the ophthalmologists because of its cost-effectiveness and lesser side effects. Aim: The aim of study was to evaluate the role of MMC as an adjuvant therapy intraoperatively and postoperatively in the management of OSSN. Methodology: Patients in the age group of 40 years and above with a diagnosis of OSSN were included as our study subjects. The diagnosis of OSSN was made based on the clinical presentation and the cytological picture. A total of 22 patients with OSSN were taken as our study subjects. The tumor was surgically removed in toto along with 3–4 mm of uninvolved conjunctiva. Further, 0.4 mg/ml of MMC was applied over the excised site. Postoperatively, two cycles of 0.04% MMC eye drops were given for 2 weeks with a dosage of 4 times/day. It is given in two cycles, each cycle lasting for a week with an interval of 1 week in between. Results: Postoperatively, only one patient (4.5%) had recurrence which had developed after 6 months. Patients aged more than 60 years and who had the initial size of the lesion as > 8 mm were more prone to recurrence. Other postoperative complications that had occurred were one patient had allergic conjunctivitis and the other patient had punctate erosion. Conclusion: The use of MMC eye drop in the concentration of 0.04% has shown good clinical results without any serious side effects and with a very less recurrence rate during the follow-up period of 1 year when used as alternate 7-day courses.