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Microscopically controlled excision of conjunctival squamous cell carcinoma
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida.
American Journal of Ophthalmology
|January 15, 1994
Summary
This study introduces a tissue-sparing surgical technique for conjunctival squamous cell carcinoma, achieving high cure rates with minimal complications. The method ensures clear surgical margins, preventing tumor recurrence in treated patients.
Area of Science:
- Ophthalmology
- Surgical Oncology
- Dermatopathology
Background:
- Conjunctival squamous cell carcinoma (cSCC) management often relies on surgical excision, but achieving tumor-free margins can be challenging.
- Standard excision techniques may not guarantee complete removal of microscopic tumor extensions, risking recurrence.
Purpose of the Study:
- To evaluate the efficacy of a Mohs' micrographic technique adaptation for managing conjunctival squamous cell carcinoma.
- To assess the oncologic outcomes and complications associated with this tissue-sparing approach for cSCC.
Main Methods:
- A modified Mohs' micrographic technique was employed for initial tumor excision, with immediate histologic margin review.
- Lamellar sclerectomy was performed for positive deep margins, and cryotherapy was used in one case.
- Tumor-free defects were allowed to heal by secondary intention, with follow-up ranging from 6 to 60 months.
Main Results:
- Nineteen patients with cSCC were treated using this technique.
- No tumor recurrences were documented during the follow-up period.
- The primary complication was conjunctival scarring leading to restricted motility in one patient.
Conclusions:
- This tissue conservation method, involving meticulous margin surveillance, offers a high cure rate for conjunctival squamous cell carcinoma.
- The technique appears safe and effective, with a low complication profile compared to traditional methods.