AS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C

Tarek Roshdy Elhamaky, Ahmed Mohammed Elbarky Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, EgyptCorrespondence: Tarek Roshdy ElhamakyDepartment of Ophthalmology, Benha Faculty of Medicine, Benha University, Qalyubiya Governorate, Benha 13511, EgyptTel +20133227819...

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Autores principales: Elhamaky TR, Elbarky AM
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Publicado: Dove Medical Press 2019
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spelling oai:doaj.org-article:9a591be0dae346bd898511083333b9592021-12-02T09:44:10ZAS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C1177-5483https://doaj.org/article/9a591be0dae346bd898511083333b9592019-11-01T00:00:00Zhttps://www.dovepress.com/as-oct-guided-treatment-of-diffuse-conjunctival-squamous-cell-carcinom-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Tarek Roshdy Elhamaky, Ahmed Mohammed Elbarky Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, EgyptCorrespondence: Tarek Roshdy ElhamakyDepartment of Ophthalmology, Benha Faculty of Medicine, Benha University, Qalyubiya Governorate, Benha 13511, EgyptTel +20133227819Fax +20133256457Email dr_thamakyy@yahoo.comPurpose: To evaluate the efficacy of combined limited surgical resection, amniotic membrane graft and topical mitomycin C in treatment of diffuse conjunctival squamous cell carcinoma (CSCC) diagnosed and followed up by anterior segment optical coherence tomography (AS-OCT).Subjects and methods: A prospective study was performed on 24 eyes with diffuse CSCC. Fifteen eyes underwent lesion limited resection followed by postoperative topical mitomycin C 0.04% eye drop (MMC group) while nine eyes underwent complete excision and cryotherapy (no MMC group). Amniotic membrane graft was applied in all cases. The diagnosis was based on clinical and AS-OCT specific criteria of CSCC and was confirmed by histopathological results.Results: The study population was similar between the two groups. Mean postoperative follow-up was 27.1±4.1 months. The mean extent of the limbal involvement was 7.0±0.7 and 7.25±0.6 clock hours in MMC and no MMC groups, respectively. The mean size of conjunctival defect after tumor excision in MMC group (60.8±9.2 mm2) was significantly lower than in no MMC group (92.4±17.3 mm2). Histopathological diagnosis revealed invasive SCC in all specimens. The mean preoperative conjunctival epithelial thickness decreased significantly in both groups at 2-year follow-up. It decreased from 267±24.2 and 256±19.1 μm preoperatively to 56.7±11.6 and 60.4±9.6 μm at 2-year follow-up in MMC and no MMC groups, respectively. The mean number of MMC treatment cycles was 2.1±0.85 cycles. Recurrence was recorded in zero (0%) and 1 (11%) patients at 2-year follow-up in MMC and no MMC groups, respectively. Histopathological diagnosis revealed invasive SCC in all specimens. The mean preoperative conjunctival epithelial thickness decreased significantly in both groups at 2-year follow-up. It decreased from 267±24.2 and 256±19.1 μm preoperatively to 56.7±11.6 and 60.4±9.6 μm at 2-year follow-up in MMC and no MMC groups, respectively. The mean number of MMC treatment cycles was 2.1±0.85 cycles. Recurrence was recorded in zero (0%) and 1 (11%) patients at 2-year follow-up in MMC and no MMC groups, respectively.Conclusion: The treatment of diffuse CSCC with AS-OCT guided combined therapy includes limited surgical resection, AMG, and postoperative topical MMC, achieves a complete tumor resolution and good functional and cosmetic outcomes minimizing the burden of surgery, and improves postoperative patient comfort in our study cohort.Keywords: diffuse, conjunctival squamous cell carcinoma, mitomycin C, AS-OCT, amniotic membrane graftElhamaky TRElbarky AMDove Medical Pressarticlediffuseconjunctival squamous cell carcinomamitomycin cas-octamniotic membrane graftOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 2269-2278 (2019)
institution DOAJ
collection DOAJ
language EN
topic diffuse
conjunctival squamous cell carcinoma
mitomycin c
as-oct
amniotic membrane graft
Ophthalmology
RE1-994
spellingShingle diffuse
conjunctival squamous cell carcinoma
mitomycin c
as-oct
amniotic membrane graft
Ophthalmology
RE1-994
Elhamaky TR
Elbarky AM
AS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C
description Tarek Roshdy Elhamaky, Ahmed Mohammed Elbarky Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, EgyptCorrespondence: Tarek Roshdy ElhamakyDepartment of Ophthalmology, Benha Faculty of Medicine, Benha University, Qalyubiya Governorate, Benha 13511, EgyptTel +20133227819Fax +20133256457Email dr_thamakyy@yahoo.comPurpose: To evaluate the efficacy of combined limited surgical resection, amniotic membrane graft and topical mitomycin C in treatment of diffuse conjunctival squamous cell carcinoma (CSCC) diagnosed and followed up by anterior segment optical coherence tomography (AS-OCT).Subjects and methods: A prospective study was performed on 24 eyes with diffuse CSCC. Fifteen eyes underwent lesion limited resection followed by postoperative topical mitomycin C 0.04% eye drop (MMC group) while nine eyes underwent complete excision and cryotherapy (no MMC group). Amniotic membrane graft was applied in all cases. The diagnosis was based on clinical and AS-OCT specific criteria of CSCC and was confirmed by histopathological results.Results: The study population was similar between the two groups. Mean postoperative follow-up was 27.1±4.1 months. The mean extent of the limbal involvement was 7.0±0.7 and 7.25±0.6 clock hours in MMC and no MMC groups, respectively. The mean size of conjunctival defect after tumor excision in MMC group (60.8±9.2 mm2) was significantly lower than in no MMC group (92.4±17.3 mm2). Histopathological diagnosis revealed invasive SCC in all specimens. The mean preoperative conjunctival epithelial thickness decreased significantly in both groups at 2-year follow-up. It decreased from 267±24.2 and 256±19.1 μm preoperatively to 56.7±11.6 and 60.4±9.6 μm at 2-year follow-up in MMC and no MMC groups, respectively. The mean number of MMC treatment cycles was 2.1±0.85 cycles. Recurrence was recorded in zero (0%) and 1 (11%) patients at 2-year follow-up in MMC and no MMC groups, respectively. Histopathological diagnosis revealed invasive SCC in all specimens. The mean preoperative conjunctival epithelial thickness decreased significantly in both groups at 2-year follow-up. It decreased from 267±24.2 and 256±19.1 μm preoperatively to 56.7±11.6 and 60.4±9.6 μm at 2-year follow-up in MMC and no MMC groups, respectively. The mean number of MMC treatment cycles was 2.1±0.85 cycles. Recurrence was recorded in zero (0%) and 1 (11%) patients at 2-year follow-up in MMC and no MMC groups, respectively.Conclusion: The treatment of diffuse CSCC with AS-OCT guided combined therapy includes limited surgical resection, AMG, and postoperative topical MMC, achieves a complete tumor resolution and good functional and cosmetic outcomes minimizing the burden of surgery, and improves postoperative patient comfort in our study cohort.Keywords: diffuse, conjunctival squamous cell carcinoma, mitomycin C, AS-OCT, amniotic membrane graft
format article
author Elhamaky TR
Elbarky AM
author_facet Elhamaky TR
Elbarky AM
author_sort Elhamaky TR
title AS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C
title_short AS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C
title_full AS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C
title_fullStr AS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C
title_full_unstemmed AS-OCT Guided Treatment Of Diffuse Conjunctival Squamous Cell Carcinoma With Resection, Amniotic Membrane Graft And Topical Mitomycin C
title_sort as-oct guided treatment of diffuse conjunctival squamous cell carcinoma with resection, amniotic membrane graft and topical mitomycin c
publisher Dove Medical Press
publishDate 2019
url https://doaj.org/article/9a591be0dae346bd898511083333b959
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