Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
International Ophthalmology
Published in: International Ophthalmology 1/2017

01-02-2017 | Original Paper

Long-term outcome of amniotic membrane transplantation combined with mitomycin C for conjunctival reconstruction after ocular surface squamous neoplasia excision

Authors: Kazuomi Hanada, Noriko Nishikawa, Naoyuki Miyokawa, Akitoshi Yoshida

Published in: International Ophthalmology | Issue 1/2017

Login to get access

Abstract

The aim of the study is to evaluate the long-term clinical results of amniotic membrane transplantation (AMT) combined with mitomycin C (MMC) for reconstruction of conjunctival defects created during the excision of ocular surface squamous neoplasia (OSSN). Eight consecutive eyes of seven patients (five males and two females; mean age, 64 ± 19 years) treated by one surgeon (KH) were included in this study. AMT was performed after excision of a mass region, along with 0.04 % MMC treatment for the exposed sclera. The tumor size, histopathological retrieval, AM graft size after tumor excision, recurrence, and postoperative complications were recorded. During a mean postoperative follow-up period of 60.9 ± 14.6 months (range 36–78 months), the ocular surfaces completely re-epithelialized in all cases. The median size of the tumor was 44.4 ± 21.2 mm2 (range 13–67 mm2). The histopathological diagnoses were five cases of squamous cell carcinoma in situ (SCC in situ) and three cases of dysplasia. The median size of the AM graft after tumor excision was 100.8 ± 32.7 mm2 (range 49–151 mm2). A case of recurrent SCC in situ with a preoperative history of using MMC eye drops developed further corneal limbal deficiency and was treated with therapeutic soft contact lenses. A case of dysplasia with a history of large pterygial excision developed symblepharon postoperatively was treated with AMT 6 months after tumor excision. The tumors recurred in two eyes with SCC in situ and were successfully treated with continuous AMT and MMC. No severe complications, such as infections, corneal or scleral thinning, or ulceration developed in all cases. The combination of AMT and MMC is effective for safe reconstruction over the long-term after the excision of OSSN with postoperative careful observation and treatment. In recurrent tumor excision cases, AMT is a suitable technique for repeated ocular surface reconstruction.
Literature
1.
Shields JA, Shields CL, DePotter P (1997) Surgical management of conjunctival tumors: the 1994 Lynn B McMahan Lecture. Arch Ophthalmol 115:808–815CrossRefPubMed
2.
Kim JC, Tseng SCG (1995) Transplantation of preserved human amniotic membrane for surface reconstruction in severely damaged rabbit corneas. Cornea 14:472–484CrossRef
3.
Tsubota K, Satake Y, Ohyama M, Toda I, Takano Y, Ono M, Shinozaki N, Shimazaki J (1996) Surgical reconstruction of the ocular surface in advanced ocular cicatricial pemphigoid and Stevens-Johnson syndrome. Am J Ophthalmol 122:38–52CrossRefPubMed
4.
Shimazaki J, Yang H-Y, Tsubota K (1997) Amniotic membrane transplantation for ocular surface reconstruction in patients with chemical and thermal burns. Ophthalmology 104:2068–2076CrossRefPubMed
5.
Lee SH, Tseng SCG (1997) Amniotic membrane transplantation for persistent epithelial defects with ulceration. Am J Ophthalmol 123:303–312CrossRefPubMed
6.
Shimazaki J, Shinozaki N, Tsubota K (1998) Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon. Br J Ophthalmol 82:235–240CrossRefPubMedPubMedCentral
7.
Kruse FE, Rohrschneider K, Völcker HE (1999) Multilayer amniotic membrane transplantation for reconstruction of deep corneal ulcers. Ophthalmology 106:1504–1511CrossRefPubMed
8.
Hanada K, Shimazaki J, Shimmura S, Tsubota K (2001) Multilayered amniotic membrane transplantation for severe ulceration of the cornea and sclera. Am J Ophthalmol 131:324–331CrossRefPubMed
9.
Shields CL, Shields JA, Armstrong T (2001) Management of conjunctival and corneal melanoma with surgical excision, amniotic membrane allograft, and topical chemotherapy. Am J Ophthalmol 132:576–578CrossRefPubMed
10.
Espana EM, Prabhasawat P, Gruetrich M, Solomon A, Tseng SCG (2002) Amniotic membrane transplantation for reconstruction after excision of large ocular surface neoplasias. Br J Ophthalmol 86:640–645CrossRefPubMedPubMedCentral
11.
Gündüz K, Uçakhan ÖÖ, Kanpolat A, Günalp I (2006) Nonpreserved human amniotic membrane transplantation for conjunctival reconstruction after excision of extensive ocular surface neoplasia. Eye 20:351–357CrossRefPubMed
12.
Asoklis RS, Damijonaityte A, Butkiene L, Makselis A, Petroska D, Pajaujis M, Juodkaite G (2011) Ocular surface reconstruction using amniotic membrane following excision of conjunctival and limbal tumors. Eur J Ophthalmol 21:552–558CrossRefPubMed
13.
Tseng SCG, Prabhasawat P, Barton K, Gray T, Meller D (1998) Amniotic membrane transplantation with or without limbal allografts for corneal surface reconstruction in patients with limbal stem cell deficiency. Arch Ophthalmol 116:431–441CrossRefPubMed
14.
Tsubota K, Satake Y, Kaido M, Shinozaki N, Shimmura S, Bissen-Miyajima H, Shimazaki J (1999) Treatment of severe ocular surface disorders with corneal epithelial stem-cell transplantation. N Engl J Med 340:1697–1703CrossRefPubMed
15.
Frucht-Pery J, Rozenman Y (1994) Mitomycin C therapy for corneal intraepithelial neoplasia. Am J Ophthalmol 117:164–168CrossRefPubMed
16.
Wilson MW, Hungerford JL, George SM, Madreperla SA (1997) Topical mitomycin C for the treatment of conjunctival and corneal epithelial dysplasia and neoplasia. Am J Ophthalmol 124:303–311CrossRefPubMed
17.
Heigle TJ, Stulting RD, Palay DA (1997) Treatment of recurrent conjunctival epithelial neoplasia with topical mitomycin C. Am J Ophthalmol 124:397–399CrossRefPubMed
18.
Frucht-Pery J, Sugar J, Baum J, Sutphin JE, Pe’er J, Savir H, Holland EJ, Meisler DM, Foster JA, Folberg R, Rozenman Y (1997) Mitomycin C treatment for conjunctival- corneal intraepithelial neoplasia—a multicenter experience. Ophthalmology 104:2085–2093CrossRefPubMed
19.
Rozenman Y, Frucht-Pery J (2000) Treatment of conjunctival corneal intraepithelial neoplasia with topical drops of mitomycin C. Cornea 19:1–6CrossRefPubMed
20.
Shields CL, Naseripour M, Shields JA (2002) Topical mitomycin C for extensive recurrent conjunctival-corneal squamous cell carcinoma. Am J Ophthalmol 133:601–606CrossRefPubMed
21.
Tseng SCG, Li DQ, Max X (1999) Suppression of transforming growth factor isoforms, TGF-β receptor II, and myofibroblast differentiation in cultured human corneal and limbal fibroblasts by amniotic membrane matrix. J Cell Physiol 179:325–335CrossRefPubMed
22.
Lee SB, Li DQ, Tan DT, Meller DC, Tseng SC (2000) Suppression of TGF-β signaling in both normal conjunctival fibroblasts and pterygial body fibroblasts by amniotic membrane. Curr Eye Rec 20:325–334CrossRef
23.
Hayasaka S, Noda S, Yamamoto Y, Setogawa T (1988) Postoperative instillation of low-dose mitomycin C in the treatment of primary pterygium. Am J Ophthalmol 106:715–718CrossRefPubMed
24.
Hayasaka S, Noda S, Yamamoto Y, Setogawa T (1989) Postoperative instillation of mitomycin C in the treatment of recurrent pterygium. Ophthal Surg 20:580–583
25.
Chen CW, Huang HT, Bair JS (1990) Trabeculectomy with simultaneous topical application of mitomycin C in refractory glaucoma. J Ocul Pharmacol 6:175–182CrossRefPubMed
26.
Palmer SS (1991) Mitomycin C as adjunct chemotherapy with trabeculectomy. Ophthalmology 98:317–321CrossRefPubMed
27.
Tseng SC, Di Pascuale MA, Liu DT, Gao YY, Baradaran-Rafii A (2005) Intraoperative mitomycin C and amniotic membrane transplantation for fornix reconstruction in severe cicatricial ocular surface diseases. Ophthalmology 112:896–903CrossRefPubMed
Metadata
Title
Long-term outcome of amniotic membrane transplantation combined with mitomycin C for conjunctival reconstruction after ocular surface squamous neoplasia excision
Authors
Kazuomi Hanada
Noriko Nishikawa
Naoyuki Miyokawa
Akitoshi Yoshida
Publication date
01-02-2017
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 1/2017
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-016-0231-6

Other articles of this Issue 1/2017

International Ophthalmology 1/2017 Go to the issue

Original Paper

Epidemiology and clinical outcome of intraocular foreign bodies in Hong Kong: a 13-year review

Original Paper

Central corneal thickness and corneal curvature in patients with rheumatoid arthritis

Original Paper

Relationship between mean platelet volume and central serous chorioretinopathy

Original Paper

Measurements of central corneal thickness and endothelial parameters with three different non-contact specular microscopy devices

Original Paper

Comparison of intraocular pressure variability in glaucoma measured by multiple clinicians with those by one clinician

Original Paper

Confocal microscopy evaluation of stromal fluorescence intensity after standard and accelerated iontophoresis-assisted corneal cross-linking