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Surgical, medical treatments for squamous neoplasia both have pros, cons
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LAS VEGAS — Ocular surface squamous neoplasia is one of the most common nonpigmented tumors of the ocular surface, and there is much debate regarding which treatment to choose, according to a presentation here.
At the American Academy of Ophthalmology annual meeting, Carol L. Karp, MD, weighed the pros and cons of excision alone with a no-touch technique and of treatment with chemotherapeutic agents such as mitomycin C, 5-fluorouracil (5-FU) and interferon-alpha-2b.
Surgery can be a quick resolution that can be covered by insurance, but it is hard to ensure clear margins, and an extensive excision can cause scarring. On the other hand, medication treats the entire ocular surface and has varying options, but treatment takes a long period of time, patient compliance and out-of-pocket costs.
Therefore, for a large lesion or multiple recurrences, Karp suggests using chemotherapeutic medications. If compliance with therapy is an issue, then she suggests surgery. Additionally, if the diagnosis is in doubt, “then surgery is going to be both therapeutic and diagnostic,” she said.
When comparing the various medications, if a patient cannot afford the treatment, Karp prefers 5-FU; if not, she prefers interferon.
“Sometimes it is easy to cure a tumor, and sometimes it is not. Be ready to combine your treatment modalities,” Karp said. — by Kristie L. Kahl
Disclosure: Karp reports no relevant financial disclosures.
Reference:
Karp CL. Ocular surface squamous neoplasia: surgery, interferon, 5 FU, or mitomycin. Presented at: American Academy of Ophthalmology annual meeting. Nov. 14, 2015; Las Vegas.