Kusumesh Rakhi, Ambastha Anita, Kumar Shishir, Sinha Bibhuti Prasan, Imam Nazia
*Cornea Services, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, India; †Community Ophthalmology, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, India; ‡Department of Biostatistics, Indira Gandhi Institute of Medical Sciences, Patna, India; and §Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, India.
Cornea. 2017 Mar;36(3):327-331. doi: 10.1097/ICO.0000000000001116.
To compare the efficacy and safety of topical interferon alpha 2b (IFNα2b) and mitomycin C (MMC) for ocular surface squamous neoplasia.
In this retrospective study, medical records of 51 eyes of 50 patients with a diagnosis of primary ocular surface squamous neoplasia were included. All cases were treated with either topical IFNα2b (1 million IU/mL) or MMC (0.4 mg/mL) 4 times a day. The primary outcome measure was frequency of clinical resolution of tumors along with failure and recurrence rates after treatment. Other outcome measures included the duration of treatment and adverse effects associated with both topical therapies.
Twenty-six eyes were treated with topical IFNα2b and 25 eyes were treated with topical MMC. A complete response was achieved in 23 (89%) and 23 (92%) eyes with topical IFNα2b and MMC, respectively (P = 0.67). The median time to lesion resolution was significantly different between the groups (median 3.5 months in the IFNα2b group and 1.5 months in the MMC group) with an average difference of 1.7 months (P < 0.005). Five (10%) of 51 patients showed no or partial response to topical therapy. Subsequently, they underwent surgical excision. Adverse effects occurred in 3 (12%) patients using IFNα2b and 22 (88%) patients using MMC (P < 0.005).
Both IFNα2b and MMC seemed to be equally effective topical monotherapies. Despite a prolonged time to lesion resolution, IFNα2b-treated eyes had better safety and tolerance in comparison with MMC-treated eyes.
比较局部应用干扰素α2b（IFNα2b）和丝裂霉素C（MMC）治疗眼表鳞状上皮病变的疗效和安全性。
在这项回顾性研究中，纳入了50例诊断为原发性眼表鳞状上皮病变患者的51只眼的病历。所有病例均接受局部应用IFNα2b（100万IU/mL）或MMC（0.4mg/mL），每日4次治疗。主要观察指标为肿瘤临床消退频率以及治疗后的失败和复发率。其他观察指标包括治疗持续时间以及与两种局部治疗相关的不良反应。
26只眼接受局部IFNα2b治疗，25只眼接受局部MMC治疗。局部应用IFNα2b和MMC分别有23只眼（89%）和23只眼（92%）获得完全缓解（P = 0.67）。两组病变消退的中位时间有显著差异（IFNα2b组中位时间为3.5个月，MMC组为1.5个月），平均差异为1.7个月（P < 0.005）。51例患者中有5例（10%）对局部治疗无反应或部分反应。随后，他们接受了手术切除。使用IFNα2b的3例（12%）患者和使用MMC的22例（88%）患者出现了不良反应（P < 0.005）。
IFNα2b和MMC似乎都是同样有效的局部单一疗法。尽管病变消退时间较长，但与接受MMC治疗的眼相比，接受IFNα2b治疗的眼具有更好的安全性和耐受性。
