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Ocular surface squamous neoplasia: To cut or not to cut

机译：眼表鳞状上皮增生：切开或不切开

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摘要

The goal of treating ocular surface squamous neo-plasia (OSSN) is to eliminate all neoplastic squamous epithelium and prevent recurrence without causing complications or side effects. There are several recognized pathways of trying to achieve this goal but no universally accepted gold standard of treatment. Surgical excision with adjunctive cryotherapy or topical chemotherapy has been used for years with good success. Surgical excision removes the clinically macroscopic disease and confirms the histological degree of neoplasia. Adjunctive cryotherapy and chemotherapy can reduce the recurrence rate compared with surgery alone. Large tumours, however, are best not treated with surgery because of the side effects induced by large areas of limbal and conjunc-tival epithelial removal. Surgery and cryotherapy also fail to address clinically undetectable and sometimes widespread microscopic disease. More recently, there has been a paradigm shift to the use of topical chemotherapy as adjuncts to surgery or as primary therapy alone.
机译：治疗眼表鳞状上皮增生（OSSN）的目的是消除所有赘生性鳞状上皮并预防​​复发而不会引起并发症或副作用。有几种公认的途径试图实现这一目标，但没有公认的黄金治疗标准。辅助冷冻疗法或局部化学疗法的手术切除已经使用了多年，取得了良好的成功。手术切除可消除临床上的宏观疾病，并确认肿瘤的组织学程度。与单纯手术相比，辅助冷冻疗法和化学疗法可降低复发率。但是，由于大面积的角膜缘和结膜上皮切除会引起副作用，因此最好不要手术治疗大肿瘤。外科手术和冷冻疗法也无法解决临床上无法检测到的，有时是广泛存在的微观疾病。最近，已经发生了范式转变，将局部化疗用作手术的辅助手段或仅作为主要疗法。

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