M Palamar1, E Kaya1, S Egrilmez1, T Akalin2, A Yagci1. 1. Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey. 2. Department of Pathology, Ege University Faculty of Medicine, Izmir, Turkey.
Abstract
OBJECTIVE: To evaluate the long-term efficacy of amniotic membrane transplantation for ocular surface reconstruction in the surgical management of ocular surface squamous neoplasia (OSSN). METHODS: OSSN in 21 patients (7 female, 14 male patients) was managed with excisional biopsy, cryotherapy, corneal epitheliectomy with absolute alcohol application when the cornea is involved, lamellar sclerectomy and adjunctional absolute alcohol application to the base when episclera is involved, and ocular surface reconstruction with cryopreserved amniotic membrane transplantation. Tumor control and complications were evaluated. RESULTS: The mean age of the patients was 62.42 ± 20.9 (range, 16-84). The average diameter of the base of the tumors was 13.1 ± 4.8 (range, 9-21) mm and complete removal was achieved in all cases as revealed histopathologically. Ocular surface healing was achieved in all cases. At the postoperative period, limbal stem cell deficiency in three eyes and mild symblepharon in one eye were detected. In a mean follow-up of 30.95 ± 18.8 (range, 13-75) months, no recurrence was detected. CONCLUSION: For large or multifocal conjunctival tumors, the reconstruction of ocular surface and fornix is challenging. The amniotic-membrane use to repair conjunctival defects larger than 10 mm is a safe and effective technique with minimal complications allowing surgeons to make large enough excisions.
OBJECTIVE: To evaluate the long-term efficacy of amniotic membrane transplantation for ocular surface reconstruction in the surgical management of ocular surface squamous neoplasia (OSSN). METHODS: OSSN in 21 patients (7 female, 14 male patients) was managed with excisional biopsy, cryotherapy, corneal epitheliectomy with absolute alcohol application when the cornea is involved, lamellar sclerectomy and adjunctional absolute alcohol application to the base when episclera is involved, and ocular surface reconstruction with cryopreserved amniotic membrane transplantation. Tumor control and complications were evaluated. RESULTS: The mean age of the patients was 62.42 ± 20.9 (range, 16-84). The average diameter of the base of the tumors was 13.1 ± 4.8 (range, 9-21) mm and complete removal was achieved in all cases as revealed histopathologically. Ocular surface healing was achieved in all cases. At the postoperative period, limbal stem cell deficiency in three eyes and mild symblepharon in one eye were detected. In a mean follow-up of 30.95 ± 18.8 (range, 13-75) months, no recurrence was detected. CONCLUSION: For large or multifocal conjunctival tumors, the reconstruction of ocular surface and fornix is challenging. The amniotic-membrane use to repair conjunctival defects larger than 10 mm is a safe and effective technique with minimal complications allowing surgeons to make large enough excisions.
Authors: Carol L Karp; Carolina Mercado; Nandini Venkateswaran; Marco Ruggeri; Anat Galor; Armando Garcia; Kavitha R Sivaraman; Maria Paula Fernandez; Antonio Bermudez; Sander R Dubovy Journal: Am J Ophthalmol Date: 2019-06-01 Impact factor: 5.258