Iatrogenic Ocular Surface Diseases Occurring during and/or after Different Treatments for Ocular Tumours

Abstract

The ocular surface represents a finely regulated system that allows the protection of the eye. It is particularly susceptible to different treatments for intraocular tumours, such as uveal melanoma and conjunctival cancers. Traditionally, the management of ocular tumours depends on the characteristics of the lesion, and is based on a combination of selective surgery, topical chemotherapy, and/or radiotherapy delivered through different mechanisms (e.g., charged-particle radiotherapy or brachytherapy). Possible complications involving the ocular surface range from transient dry eye disease or keratitis up to corneal melting and perforation, which in any case deserve careful evaluation for the risk of permanent sigh-threatening complications. Clinicians involved in the management of these patients must be aware of this risk, in order to reach an early diagnosis and promptly set up an adequate treatment. The present review of the literature will summarize acute and chronic complications affecting the ocular surface following different therapies for the treatment of ocular tumours.

Radiotherapy in Uveal Melanoma: A Review of Ocular Complications

“…Ocular Surface and Ocular adnexa complications Artificial tears, topical corticosteroids, and antibiotic treatment [20] Reconstructive surgery, tarsorrhaphy, or gold weight implantation [20] Contact lenses, autologous serum eye drops, conjunctival flaps, amniotic membrane transplantation, cyanoacrylate gluing [20,21] Lamellar or penetrating keratoplasty [20,21] Scleral Necrosis Observation Artificial lubrication, gels or ointments, like prednisolone acetate 1% [22][23][24][25][26][27][28] Surgical techniques [22][23][24][25][26][27][28] • Tissue glue…”

Human Papillomavirus Related Neoplasia of the Ocular Adnexa

“…A systematic review of the literature reported a mean risk of recurrence at 52% in cases with positive surgical margins and 11% in cases with negative surgical margins [ 31 ]. Adjuvant therapy, including topical or intralesional chemotherapy, radiotherapy, or plaque brachytherapy, further reduces the persistence of the tumors and the recurrence rates, independent of margin status, but may also cause considerable side effects [ 29 , 32 ]. The application of adjuvant topical interferon alpha-2b in cases with narrow, indeterminate, or negative surgical margins seems to obtain better tumor control than re-excision, incisional biopsy-guided interferon alpha-2b therapy, or empiric interferon alpha-2b treatment as monotherapy [ 31 ].…”