Venugopal Anitha

Abstract

Purpose: To report a rare association of conjunctival squamous cell carcinoma with the benign skin condition, Verruca Vulgaris, with the common aetiology being HPV. Case Report: A 30 year-old-male with benign, diffuse, verrucous lesions all over the skin, presented with conjunctival squamous cell carcinoma, involving more than 180 degree of the limbus and cornea was treated successfully with topical chemotherapy without recurrence. HPV infection is the predisposing to both these conditions. Results: The association of Verruca Vulgaris and Conjunctival papilloma has been established to a great degree in literature along with the common etiological factor HPV, and not conjunctival Squamous cell carcinoma, is the peculiarity of this case report. Keywords: Verruca Vulgaris, Conjunctival Squamous Neoplasia, OSSN, Mitomycin -C.

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Abstract

Introduction: Aim of the study is to analyse the outcomes of Descemet’s stripping endothelial keratoplasty (DSEK) for corneal oedema in patients with secondary glaucoma. Our’s is retrospective review of the outcomes of DSEK that was performed for corneal decompensation in patients with secondary glaucoma. Materials and Methods: A total of 93 patients, of which 17 had been diagnosed with secondary glaucoma, were included in the study. All patients underwent medical or surgical treatment to control intraocular pressure (IOP) before DSEK. The clinical outcomes of DSEK in these patients were evaluated. The data collected included demographic patterns, indications, medical or surgical treatment for glaucoma, intra-operative and post-operative complications of DSEK, IOP changes before and after DSEK, and post-operative visual outcomes. The data were analysed based on the different aetiologies of secondary glaucoma such as iridocorneal endothelial (ICE) syndrome, pseudoexfoliation (PXF) syndrome, glaucoma in pseudophakia, traumatic glaucoma, and inflammatory glaucoma. The average IOP of each patient was calculated using both applanation tonometry and Tono-pen before and after DSEK and at every follow-up. Main Outcome Measures Graft clarity, IOP changes, and visual outcomes after DSEK were evaluated for all patients. Results: DSEK was performed for the following causes of secondary glaucoma in descending order: PXF, 6 patients; ICE, 4 patients; glaucoma in pseudophakia, 3 patients; traumatic glaucoma, 2 patients; and inflammatory glaucoma, 2 patients. Two patients underwent trabeculectomy, 5 patients underwent aqueous tube drainage surgery, and 13 patients were administered medication before DSEK. At the 1-year followup, 14 patients had clear grafts with best corrected visual acuity (BCVA) scores greater than 6/36, while the BCVA scores of the other 3 patients were below 6/60. Conclusion: DSEK is an appropriate method for treating all types of secondary glaucoma. After DSEK, the visual recovery, refractive outcomes are superior and the rise in IOP is minimal compared to those after Full thickness Keratoplasty, since the angle anatomy and corneal contour is maintained. Keywords: Descemet’s membrane endothelial keratoplasty, Secondary glaucoma.

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