scholarly journals Resolution of giant ocular surface squamous neoplasia with topical 5-fuorouracil 1%

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984339 ◽  
Author(s):  
Karim Mohamed-Noriega ◽  
Alan Baltazar Treviño-Herrera ◽  
Abraham Olvera-Barrios ◽  
Fernando Morales-Wong ◽  
Jesus Mohamed-Hamsho

An 82-year-old man presented with a left eye elevated single ocular surface squamous neoplasia. The tumor involved 360° of limbus, three quadrants of cornea and conjunctiva; this was compatible with the diagnosis of giant ocular surface squamous neoplasia. Topical 5-fluorouracil 1% was planned four times daily for 1 week followed by 3 weeks off-treatment. Patient inadvertently continued 5-fluorouracil, four times daily for 4 weeks, presenting with clinical resolution of the ocular surface squamous neoplasia and subtotal corneal epithelial defect associated with 5-fluorouracil toxicity. One month later, we observed a transparent cornea and no signs of toxicity. Total tumor resolution was observed for at least 6 months of follow-up.

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Kaevalin Lekhanont ◽  
Passara Jongkhajornpong ◽  
Lulin Choubtum ◽  
Varintorn Chuckpaiwong

The purpose of this study was to investigate the efficacy and safety of topical 100% serum eye drops for corneal epithelial defect after ocular surgery. A total of 181 patients who received topical 100% serum therapy for the treatment of corneal epithelial defect following several different types of ocular surgery were recruited into this study. Each patient already failed conventional medical therapy before being prescribed 100% serum eye drops. Slit-lamp biomicroscopic examination with fluorescein staining was performed at baseline and all follow-up visits. The main outcome measures were the rate of complete healing of the corneal epithelial defect and incidence of adverse events. One hundred and seventy-eight eyes (98.34%) received autologous serum eye drops, and 3 (1.66%) received allogeneic serum eye drops. The overall success rate of treating persistent postoperative epithelial defect using 100% serum eye drops was 93.92% (95% CI 0.88–0.98). The median time to complete corneal epithelialization was 4 days (95% CI 4-5). Adverse reactions were observed in 3 patients (1.66%), including sticky sensation with minimal eye discomfort and asymptomatic trace corneal subepithelial infiltration. No serious complications were reported. In conclusion, 100% serum eye drops are effective, safe, and tolerable for treating postoperative corneal epithelial defect following ocular surgeries.


2021 ◽  
pp. 112067212110071
Author(s):  
Vijitha S Vempuluru ◽  
Monalisha Pattnaik ◽  
Neha Ghose ◽  
Swathi Kaliki

Purpose: To describe the risk factors, clinical presentation, management, and outcomes of patients with bilateral ocular surface squamous neoplasia (OSSN). Methods: Retrospective case series. Results: Of the 25 patients with bilateral OSSN, the mean age at diagnosis of OSSN was 31 years (median, 24 years; range, 2–60 years). Risk factors for bilateral OSSN included xeroderma pigmentosum ( n = 15, 60%), human immunodeficiency virus infection ( n = 3, 12%), conjunctival xerosis ( n = 1, 4%), and topical steroid use ( n = 1, 4%). There were no identifiable ocular or systemic risk factors in 7 (28%) patients. Presentation was synchronous in 14 (56%) and metachronous in 11 (44%) patients. Tumor morphology was bilaterally similar in 12 (48%) patients. Histopathological examination ( n = 36) revealed conjunctival intraepithelial neoplasia (CIN) grade 1 in 4 (8%); grade 2 in 7 (14%); carcinoma in situ in 5 (10%), and invasive carcinoma in 20 (40%). Primary management of OSSN ( n = 49) included excisional biopsy ( n = 31, 62%), topical immunotherapy (IFN α2B) ( n = 11; 22%), topical Mitomycin C (MMC) ( n = 3, 6%), enucleation ( n = 1, 2%), orbital exenteration ( n = 2, 4%), and plaque brachytherapy (PBT) ( n = 1, 2%). One patient was lost to follow-up after detection of tumor in the second eye. Recurrent tumors were noted in 16 (32%) eyes and binocular globe salvage was achieved in 16 (64%) patients at a mean follow up of 41 months (median 30 months; range, 1–164 months). Conclusion: OSSN occurrence can be synchronous or metachronous. Meticulous examination of the fellow eye is important for an early diagnosis of OSSN.


2017 ◽  
Vol 1 (3) ◽  
pp. 187-190
Author(s):  
Andrew C. Lee ◽  
E. Mitchel Opremcak ◽  
Christiane Hunt ◽  
Juan A. Astruc ◽  
Brian Toussaint ◽  
...  

Purpose: To present a series of cases of corneal chemical burns associated with the use of likely improperly buffered corneal lubricant gel, Goniovisc, during uncomplicated, posterior segment surgery. Methods: Cases of postoperative corneal complications following surgeries in which Goniovisc was used were collected from 6 retina practices across the United States between January and August 2016. The preoperative diagnosis, type of procedure, postoperative day 1 corneal findings, treatment method, and time to resolution of the corneal irregularity were recorded. pH testing of Goniovisc lots from this time period was performed using Hydrion litmus paper. Results: A total of 157 eyes of 156 patients were found to have corneal complications following relatively simple posterior segment surgeries in which Goniovisc was used. Findings included one or more of the following: corneal epithelial defect (84% of cases), Descemet folds (34%), stromal edema (14%), and superficial punctate keratitis (3%). Time to resolution ranged from 2 to 90 days (mean, 12 days; median, 7 days). Treatment methods included artificial tears (37%), bandage contact lens (28%), antibiotic drops (17%), antibiotic ointment (16%), and patching (9%). Two cases were treated with amniotic membrane grafts. One case required a penetrating keratoplasty due to an old laser-assisted in situ keratomileusis (LASIK) flap with a nonhealing epithelial defect that scarred significantly. Litmus testing of Goniovisc lots from this time period revealed a pH of 4 to 5. Conclusion: Chemical burns secondary to improperly buffered corneal lubricant solution should be considered in the differential when corneal injury is encountered following posterior segment surgery.


2020 ◽  
pp. 002215542098007
Author(s):  
Yu-Ting Xiao ◽  
Hua-Tao Xie ◽  
Xin Liu ◽  
Chao-Ye Duan ◽  
Jing-Yu Qu ◽  
...  

Rat limbal niche cells (LNCs) have been proven to induce transdifferentiation of oral mucosal epithelial cells (OMECs) into corneal epithelial-like cells termed transdifferentiated oral mucosal epithelial cells (T-OMECs). This investigation aimed to evaluate the effect of subconjunctival T-OMEC injections on alkali-induced limbal stem cell deficiency (LSCD) in rats. LNCs were cocultured with OMECs in the Transwell system to obtain T-OMECs, with NIH-3T3 cells serving as a control. Subconjunctival injection of single T-OMEC or OMEC suspension was performed immediately after corneal alkali injury. T-OMECs were prelabeled with the fluorescent dye CM-DiI in vitro and tracked in vivo. Corneal epithelial defect, opacity, and neovascularization were quantitatively analyzed. The degree of corneal epithelial defect (from day 1 onward), opacity (from day 5 onward), and neovascularization (from day 2 onward) was significantly less in the T-OMEC group than in the OMEC group. Cytokeratin 12 (CK12), pigment epithelium–derived factor, and soluble fms-like tyrosine kinase-1 were expressed at a higher rate following T-OMEC injection. Some CM-DiI-labeled cells were found to be coexpressed with CK12, Pax6, and ΔNp63α in the corneal epithelium after subconjunctival injection. Subconjunctival injection of T-OMECs prevents conjunctival invasion and maintains a normal corneal phenotype, which might be a novel strategy in the treatment of LSCD:


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