PROSE scleral lens: a novel aid for staged eyelid reconstruction.

A 50-year-old man presented with a papillomatous tarsoconjunctival tumor involving the medial two-thirds of the left upper eyelid. Office biopsy revealed papillary squamous cell carcinoma (SCCA). Rapid tumor growth with caruncular and forniceal conjunctival involvement continued, despite a trial of weekly interferon-α2b intralesional injection therapy. Surgical excision with clear margins resulted in a large upper eyelid defect. The suspicion for recurrence remained, given the aggressive nature of the tumor. A temporary prosthetic replacement of the ocular surface ecosystem (PROSE) scleral lens was fit for preservation of the ocular surface and visual function during a 1-month observation period. No evidence of recurrence was noted, and the eyelid defect was successfully reconstructed with a Cutler-Beard procedure. Local disease was controlled; unfortunately, metastatic disease was found in the ipsilateral parotid gland 1 year later. Aggressive surgical removal is recommended in interferon-α2b nonresponsive SCCA tumors. The PROSE scleral contact lens may serve as a useful adjunct for the maintenance of a healthy ocular surface and visual function during delayed eyelid defect repair.
AuthorsDavid B Samimi, Gloria B Chiu, Michael A Burnstine
JournalOphthalmic plastic and reconstructive surgery (Ophthal Plast Reconstr Surg) 2014 Sep-Oct Vol. 30 Issue 5 Pg. e119-21 ISSN: 1537-2677 [Electronic] United States
PMID24317103 (Publication Type: Case Reports, Journal Article)
  • Carcinoma, Squamous Cell (pathology, surgery)
  • Conjunctival Neoplasms (pathology, surgery)
  • Contact Lenses
  • Ecosystem
  • Eyelid Neoplasms (pathology, surgery)
  • Humans
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures
  • Reconstructive Surgical Procedures
  • Sclera

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