EC Ophthalmology

Objective: To evaluate the effectiveness of an impression cytology-guided Mitomycin C treatment strategy in the management of Ocular Surface Squamous Neoplasia (OSSN) and to assess the outcomes of this management approach.

Materials and Methods: A prospective study was conducted at a tertiary healthcare centre, including 21 patients with cytologically diagnosed and histologically confirmed OSSN. Data collected included patient demographics, lesion characteristics, and treatment modalities, which encompassed both surgical excision and MMC therapy. The duration and dosage of MMC therapy were specifically tailored based on the findings from impression cytology. Following treatment, outcomes were meticulously analysed to assess the efficacy of this guided approach, including the resolution of OSSN, recurrence rates, and any associated adverse effects.

Results: Male predominance (61.9%) was observed among the patients, with a mean age of 43 years at presentation. Lesions were categorized by size and managed accordingly: lesions less than 5 mm underwent surgical excision followed by mitomycin C (MMC) in 38% of cases, while lesions between 5 - 10 mm were predominantly treated with MMC followed by surgical excision and additional MMC therapy (52.3%) and larger lesions exceeding 10 mm, involving critical areas like the canthus and fornices, received topical MMC 0.04% in pulse therapy in 9.52% of cases. By evaluating cellular morphology by impression cytology, MMC therapy was tailored more precisely. Post-treatment, 100% of patients experienced immediate symptomatic relief, with a recurrence rate of 9.52% in xeroderma patient with multisystem involvement. No significant MMC-related side effects were reported.

Conclusion: Mitomycin C demonstrated efficacy in treating OSSN, contributing to symptomatic relief and reducing recurrence rates without notable side effects. Tailored treatment strategies based on lesion size, location and cytological findings were effective in optimizing outcomes. Further research should explore multicentre trials to validate these findings and investigate emerging treatment modalities.

 Keywords: Ocular Surface Squamous Neoplasia; Mitomycin C; Treatment Outcomes; Lesion Size; Recurrence

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