Samimi David B, Chiu Gloria B, Burnstine Michael A
*Eyesthetica, Oculofacial and Cosmetic Surgery Associates, and †Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.
Ophthalmic Plast Reconstr Surg. 2014 Sep-Oct;30(5):e119-21. doi: 10.1097/IOP.0b013e3182a64fc9.
A 50-year-old man presented with a papillomatous tarsoconjunctival tumor involving the medial two-thirds of the left upper eyelid. Office biopsy revealed papillary squamous cell carcinoma (SCCA). Rapid tumor growth with caruncular and forniceal conjunctival involvement continued, despite a trial of weekly interferon-α2b intralesional injection therapy. Surgical excision with clear margins resulted in a large upper eyelid defect. The suspicion for recurrence remained, given the aggressive nature of the tumor. A temporary prosthetic replacement of the ocular surface ecosystem (PROSE) scleral lens was fit for preservation of the ocular surface and visual function during a 1-month observation period. No evidence of recurrence was noted, and the eyelid defect was successfully reconstructed with a Cutler-Beard procedure. Local disease was controlled; unfortunately, metastatic disease was found in the ipsilateral parotid gland 1 year later. Aggressive surgical removal is recommended in interferon-α2b nonresponsive SCCA tumors. The PROSE scleral contact lens may serve as a useful adjunct for the maintenance of a healthy ocular surface and visual function during delayed eyelid defect repair.
一名50岁男性患者，其左上前睑内侧三分之二出现乳头状睑板结膜肿瘤。门诊活检显示为乳头状鳞状细胞癌（SCCA）。尽管尝试了每周一次的干扰素-α2b病灶内注射治疗，但肿瘤仍迅速生长并累及泪阜和穹窿结膜。手术切除边缘清晰，导致上睑出现大的缺损。鉴于肿瘤的侵袭性，仍怀疑有复发。在1个月的观察期内，佩戴临时的眼表生态系统（PROSE）巩膜镜以保护眼表和视觉功能。未发现复发迹象，采用卡特勒-比尔德手术成功修复了眼睑缺损。局部疾病得到控制；不幸的是，1年后在同侧腮腺发现了转移性疾病。对于对干扰素-α2b无反应的SCCA肿瘤，建议积极手术切除。PROSE巩膜接触镜可作为在延迟眼睑缺损修复期间维持健康眼表和视觉功能的有用辅助手段。
