Khong J J, Muecke J
Department of Ophthalmology and Visual Science, Royal Adelaide Hospital, North Terrace, SA 5000, Australia.
Br J Ophthalmol. 2006 Jul;90(7):819-22. doi: 10.1136/bjo.2005.086850. Epub 2006 May 3.
To determine the complications associated with mitomycin C (MMC) in the treatment of ocular surface neoplasia.
A retrospective and consecutive study of 100 eyes in 91 patients with ocular surface neoplasia treated with MMC in a single centre between November 1998 and January 2005. Outcome measures included complications of MMC and the treatment required for these complications.
One to three 7 day cycles of topical MMC 0.04% four times a day were given to 59 eyes with localised corneal-conjunctival intraepithelial neoplasia (CIN), 19 eyes with diffuse CIN, six eyes with recurrent CIN, one eye with ocular surface squamous cell carcinoma, three eyes with primary acquired melanosis (PAM) with atypia, nine eyes with conjunctival malignant melanoma (MM), two eyes with sebaceous carcinoma with pagetoid spread, and one eye with recurrent atypical fibroxanthoma. Nine patients had bilateral CIN. 31 (34%) cases developed an allergic reaction to MMC and 14 (14%) eyes had epiphora secondary to punctal stenosis at a mean follow up period of 26.5 months.
In the largest study looking at complications of topical MMC in the treatment of ocular surface neoplasia, allergic reaction and punctal stenosis are relatively common. Serious complications were not observed suggesting the safe use of MMC in mid-term follow up.
确定丝裂霉素C(MMC)治疗眼表肿瘤相关的并发症。
对1998年11月至2005年1月在单中心接受MMC治疗的91例眼表肿瘤患者的100只眼进行回顾性连续研究。观察指标包括MMC的并发症以及针对这些并发症所需的治疗。
对59例局限性角膜结膜上皮内瘤变(CIN)患眼、19例弥漫性CIN患眼、6例复发性CIN患眼、1例眼表鳞状细胞癌患眼、3例伴有异型性的原发性获得性黑素沉着(PAM)患眼、9例结膜恶性黑色素瘤(MM)患眼、2例伴有派杰样扩散的皮脂腺癌患眼以及1例复发性非典型纤维黄色瘤患眼,给予每日4次0.04%的局部MMC,为期1至3个7天疗程。9例患者为双侧CIN。平均随访26.5个月时,31例(34%)出现对MMC的过敏反应,14只眼(14%)因泪点狭窄继发溢泪。
在关于局部MMC治疗眼表肿瘤并发症的最大规模研究中,过敏反应和泪点狭窄相对常见。未观察到严重并发症,提示MMC在中期随访中使用安全。