Objective To evaluate topical interferon alfa 2b (IFNα2b) as a single therape utic agent in the treatment of presumed recurrent corneal and conjunctival intra epithelial neoplasia. Design Noncomparative, retrospective case series. Particip ants Seven consecutive patients with recurrent corneal and conjunctival intraepi thelial neoplasia diagnosed at the University of Minnesota from July 2000 to Nov ember 2003 were studied retrospectively. All patients had a history of histologi cally proven primary corneal and conjunctival intraepithelial neoplasia and were treated by surgery, cryotherapy, radiation, and/or topical mitomycin C before r ecurrence. Intervention Patients with a clinical diagnosis of recurrent corneal and conjunctival intraepithelial neoplasia were treated with recombinant topical IFNα2b drops (1 million IU/ml) 4 times daily until lesion resolution was noted. Main outcome measures A review of medical records was performed to asse ss the duration of and response to treatment with topical IFNα2b, defined by cl inical resolution of corneal and conjunctival intraepithelial neoplasia. Results The average age of the 7 patients at the initiation of topical IFNα2b treatmen t for presumed recurrent corneal and conjunctival intraepithelial neoplasia was 68.7 years (range, 54-88). Six of 7 patients had successful treatment of recurr ent corneal and conjunctival intraepithelial neoplasia lesions with topical IFN α2b treatment. The average length of IFNα2b treatment to resolution of recurre nt corneal and conjunctival intraepithelial neoplasia was 14.5 weeks (range, 5- 24). After treatment with topical IFNα2b for recurrent corneal and conjunctival intraepithelial neoplasia, 2 patients had another recurrence of corneal and con junctival intraepithelial neoplasia, noted at 1 year and 2 months, respectively. The average post treatment follow-up was 11.7 months (range, 8-17) after the resolution of recurrent corneal and conjunctival intraepithelial neoplasia. No s ide effects of treatment were noted in any patient. Conclusions Topical IFNα2b as a single therapeutic agent is an effective treatment of presumed recurrent co rneal and conjunctival intraepithelial neoplasia. It offers the benefits of topi cal therapy and avoids the risks of surgical or other interventions specifically , ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cel l deficiency. Larger controlled studies with longer follow-up periods are recom mended to confirm the longterm efficacy and safety of this topical treatment.
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