Affiliation:
1. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL;
2. Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL;
3. Department of Ophthalmology and Visual Sciences, University of New Mexico, Albuquerque, NM; and
4. Spokane Eye Clinic, Spokane, WA.
Abstract
Purpose:
The aim of this review was to elucidate treatment preferences for ocular surface squamous neoplasia and to examine the changes in treatment modalities over the past 2 decades.
Methods:
An electronic survey was distributed to members of The Cornea Society, Ocular Microbiology and Immunology Group, and 4 international corneal specialist listservs. Questions examined medical and surgical treatment preferences, and results were compared with surveys administered in 2003 and 2012.
Results:
A total of 285 individuals responded to the survey; 90% of respondents were self-classified as corneal specialists. Seventy-three percent reported using primary topical monotherapy to treat ocular surface squamous neoplasia as compared with 58% in 2012 (P = 0.008). Compared with 2003, the percentage use of topical interferon significantly increased (P < 0.0001) from 14% to 55%, 5-fluorouracil increased (P < 0.0001) from 5% to 23%, and mitomycin C decreased (P < 0.0001) from 76% to 19% as a primary monotherapy. The frequency of performing excision without the use of postoperative adjunctive medical therapy decreased significantly (P < 0.0001), from 66% to 26% for lesions <2 mm, 64% to 12% for lesions between 2 and 8 mm, and 47% to 5% for lesions >8 mm from 2003 to 2022. More clinicians initiated topical immuno/chemotherapy without performing a biopsy as compared to 2003 (31% vs. 11%, P < 0.0001).
Conclusions:
These results demonstrate a paradigm shift in the management of ocular surface squamous neoplasia. The use of primary medical therapy as a first approach has significantly increased, with a reduction in the frequency of performing surgical excision alone.
Funder
NIH Center Core Grant
RPB Unrestricted Award
Dr. Ronald and Alicia Lepke Grant
The Lee and Claire Hager Grant
The Robert Farr Family Grant
The Grant and Diana Stanton-Thornbrough
The Robert Baer Family Grant
The Emilyn Page and Mark Feldberg Grant
The Calvin and Flavia Oak Support Fund
The Jose Ferreira de Melo Grant
The Richard and Kathy Lesser Grant
The Michele and Ted Kaplan Grant, The Roberto and Antonia Menendez Family Grant
The Stephen Takach Grant
The Christian Kathke Grant
The Ragheb Family Grant
The Honorable A. Jay Cristol Grant
The Carol Soffer Grant
Richard Azar Family Grant
Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development
Biomedical Laboratory R&D (BLRD) Service
Department of Defense Gulf War Illness Research Program
Vision Research Program
National Eye Institute
Publisher
Ovid Technologies (Wolters Kluwer Health)
Cited by
1 articles.
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