This is a retrospective interventional consecutive case series of 42 eyes of 42 patients with OSSN with histopathologically proven corneal stromal and / or scleral invasion following excision biopsy. The mean tumour basal diameter was 9.3mm and thickness of 3.1mm at presentation. Four millimetres clinically clear margin was achieved and the excised base showed invasive squamous cell carcinoma. A total dose of 5000cGy over a mean duration of 19.7 hours was provided to an axial depth of 2mm using Ru-106 surface plaque. Mean follow up was 36.9 months, and 100% of complete tumour regression was achieved. Two eyes showed recurrence of conjunctival tumour growth remote from original site of treatment. Thirty-five eyes (83%) maintained visual acuity at >20/200 and one eye had a loss of >2 Snellen lines. No lymphatic spread or systemic metastasis was found. Two eyes developed recurrent corneal epithelial defect and were treated conservatively. The authors concluded that Ru-106 is a safe and effective adjuvant therapy for this type of OSSN.
Histopathology-guided management of ocular surface squamous neoplasia (OSSN) with corneal stromal or scleral invasion using ruthenium-106 plaque brachytherapy
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