Comparison of Ocular Surface Squamous Neoplasia Recurrence with and Without Post-Surgical Mitomycin C 0.02%

BACKGROUND: Ocular surface squamous neoplasia (OSSN) is the most common non-pigmented ocular surface tumor that presents with a high recurrence rate after surgical excision. The study assesses the effectiveness of topical Mitomycin C (MMC) after surgery to minimize OSSN recurrence. METHODOLOGY: From January to December 2023, a prospective, comparative, observational study at the LRBT Eye Hospital in Karachi was conducted. Histological examination of 36 patients with OSSN showed no evidence of invasive disease. These patients were then placed in one of two groups using clinical decision making and patient preference. The first group received surgery alone, and the second group received surgery and postoperative MMC (0.02%). Patients were followed up at 1, 3, and 6 months to look for recurrence as well as complications. Statistical analysis was done using SPSS v25 and used Pearson’s Chi-Square test for recurrence difference. RESULTS: Recurrence rates at three months were 5% in the MMC group and 22% in the control group. At six months, the recurrence rate was 11% in the MMC group while the surgery-only group was 16%. Although it was not statistically significant (χ²=0.93, p=0.335), there was a trend towards lesser recurrence in the MMC group. Postoperatively, some patients had conjunctival hyperemia (25%) and conjunctival scarring (5.6%). CONCLUSION: Hence, it is suggested that adjunctive MMC may reduce OSSN recurrence after surgical excision without significant adverse effects.