Similar life quality among medically and surgically patients with ocular surface squamous neoplasia

This study characterizes vision-related and psychosocial quality of life (QoL) parameters in medically and surgically treated patients with ocular surface squamous neoplasia (OSSN).

Study design

A retrospective review of 44 patients who were treated for ocular surface squamous neoplasia (OSSN) by medical therapy with interferon alpha-2b versus surgery. Each patient completed a survey to assess the impact of treatment on their QoL.

Outcomes

Tumor resolution and recurrence were similar between both medical and surgical therapy groups. Both groups reported equal QoL satisfaction. Surgical excision tended to have better insurance coverage than medical therapy, as many patients with medical therapy had to pay for their interferon drops out of pocket. More patients tended to choose medical therapy due to fear of surgery or due to a personal literature review

Limitations

This study was performed in a retrospective manner and only 44 patients were studied. Medication regimens with greater side effects and poorer tolerability profile such as 5-Fluorouracil and mitomycin C were not analyzed, and may have possibly led to poorer QoL measures.

Clinical significance

Ocular surface squamous neoplasia can be effectively treated both by medical and surgical means. Patient reasons for choosing one or the other vary, however both patient groups report overall high rates of satisfaction between the 2 methodologies. Surgical excision is often the least financially burdensome option for treating OSSN, as insurance tends to cover surgery more completely than it does medical therapy. Patients undergoing surgical excision tend to report more pain, whereas patients choosing medical therapy more commonly reported redness, tearing and itching. The modalities cause equivalent impacts on QoL and both should be considered when counseling patients.