Ocular
Microbiology and Immunology Group
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2013
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2013
OMIG Abstract 2
Corneal and Intraocular Invasion of Ocular Surface Squamous Neoplasia
After Intraocular Surgery
Juan C. Murillo, MD1, Anat Galor, MD1, Michael C. Wu, MD2, Natasha K. Kim, MD2,
Carol L. Karp, MD1
1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami,
FL, USA.
2University of Washington School of Medicine, Seattle, WA
Purpose: To describe two unusual cases of ocular surface squamous neoplasia (OSSN) of the conjunctiva with corneal and intraocular extension following intraocular
surgery.
Methods: In this clinicopathologic small case series, two cases of OSSN managed at
two tertiary ocular institutions are described. Clinical features, pathologic characteristics
and relevant imaging are described.
Results: OSSN is considered to be a low-grade malignancy and its behavior is not
typically aggressive, unless the patient is immunocompromised. Intraocular invasion is
not common. Ocular surgery seems to facilitate intraocular extension of OSSN, with the
theory that neoplastic cells may gain entry to the eye via a penetrating incision. In both
of our cases, invasion of the OSSN was described following an intraocular surgical
procedure: cataract surgery and penetrating keratoplasty (PK). Both patients had a
history of a previous OSSN excision at the corneoscleral limbus. Case one presented
36 months after cataract surgery with progressive decrease in visual acuity and
significant corneal scarring originating from the surgical site. Penetrating keratoplasty
was performed. Histopathology reported midstromal infiltrative carcinoma. Case two
had a history of herpes simplex keratitis and underwent a repeat PK for a perforated
ulcer. Four months post-operatively there was low-grade inflammation, recalcitrant to
corticosteroid and antiviral therapy. Cytology of the anterior chamber aspirate revealed
squamous cells. Argon laser demonstrated epithelial ingrowth, which upon ultimate
surgical excision was confirmed as neoplastic ingrowth.
Conclusion: Patients with a history of OSSN may be at increased risk of neoplastic
intraocular extension following intraocular surgery.
Disclosure: N
2013
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