Role of interferon alpha 2b (IFN‐α2b) in the treatment of conjunctive squamous neoplasia

Abstract

Purpose IFN‐α2b has been postulated as an effective treatment to treat ocular surface tumors since the mid‐1990s. It could be used as a neoadjuvant agent, adjuvant therapy if there are positive margins after resection or as a primary agent for small tumors. It causes anti‐angiogenic, anti‐proliferative, cytotoxic and immunomodulatory effects. Consequently, it reduces the number of recurrences with few and mild side effects. Methods We present the case of a 77‐year‐old man with history of right eye cataract surgery who was seen in our Ophthalmology Department, due to a new appearance of a conjunctival tumor in the upper and lower temporal sectors, arriving at the bulbar conjunctiva with corneal invasion in the right eye. After performing a biopsy, squamous cell carcinoma with mild dysplasia was diagnosed. Ultrasonography and MRI were requested, ruling out infiltration. Surgical excision and amniotic membrane implantation were decided. Despite starting treatment with mitomycin C (MMC) 4 times a day, he suffered from a temporary recurrence. A second excision was performed 3 months later. This time, treatment with IFN‐α2b was started 4 times a day. Results IFN‐α2b is consolidating as a postoperative adjuvant treatment. In our case, it has managed to avoid new recurrences. We observed an asymmetric rise of the intraocular pressure (IOP) which could be associated with IFN‐α2b and need antihypertensive ocular topic treatment. Conclusion Nowadays, surgery remains the gold standard in the treatment of these tumors. Nevertheless, the high rate of recurrences and the appearance of different treatments makes search for an optimized treatment of these patients possible and necessary. IFN‐α2b stands out in terms of cost‐effectiveness and must be present among the therapeutic arsenal of any ophthalmologist who faces this carcinoma but it side effects should be studied.