Alcohol delamination and topical mitomycin-C 0.02% for the treatment of corneal intraepithelial neoplasia

Purpose To report a case of a patient diagnosed with corneal intraepithelial neoplasia (CIN) with ocular discomfort and blurred vision, successfully treated with alcohol delamination (ALD) and topical mitomycin-C.Methods A 69 year-old man underwent a full slit lamp examination which revealed the presence of a superficial corneal lesion appearing as an opaque intraepithelial plaque extending from the limbus to the visual axis. A manifest refraction with a best corrected visual acuity (BCVA), an anterior segment OCT (AS-OCT) and a corneal topography were performed. In order to remove the lesion an ALD was carried out and the obtained tissue sample was sent for histopathological evaluation confirming the diagnosis of CIN. At the end of the procedure, a bandage contact lens was applied, and the eye was started on a topical treatment with Netilmicin 3% and Dexamethasone 1% 4 times daily for 15 days and mitomycin-C 0.02% drops four times a day, on alternate weeks for 4 weeks.Results Patient's symptoms improved and BCVA was restored to 20/20 over 1-month period. The ocular surface showed a significant regularization, clinically and both at the AS-OCT and corneal topography. Three years after the procedure patient's BCVA and refraction were stable without any sign of recurrence.Conclusions ALD is a safe and inexpensive procedure when dealing with CIN allowing both clinical improvements and a definitive histopathological diagnosis.