Amniotic membrane transplantation in surgical management of ocular surface squamous neoplasias: long-term results

• Published in: Eye (London) Vol. 28; no. 9; pp. 1131 - 1135
• Main Authors: Palamar, M, Kaya, E, Egrilmez, S, Akalin, T, Yagci, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-09-2014; Nature Publishing Group
• Subjects: 692/699/67/1484; Adolescent; Adult; Aged; Aged, 80 and over; Amnion - transplantation; Biopsy; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Clinical Study; Conjunctival Neoplasms - pathology; Conjunctival Neoplasms - surgery; Corneal Diseases - pathology; Corneal Diseases - surgery; Cryotherapy; Eye Neoplasms - pathology; Eye Neoplasms - surgery; Female; Humans; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmologic Surgical Procedures; Ophthalmology; Pharmaceutical Sciences/Technology; Reconstructive Surgical Procedures; Surgery; Surgical Oncology
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2014.148

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.