Surgical excision resolves conjunctival papilloma more rapidly than medical treatment, but results in more recurrences, according to research published in Eye. These findings suggest potential utility in using both treatment methods, according to the report.
Researchers performed a retroscopic chart analysis of 30 individuals (mean age, 57.5 years; 73.3% men) with conjunctival papilloma treated between 2009 and 2020 at the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, and the Miami Veterans Affairs Hospital. Participants were treated with interferon 𝛼-2b (eyes, 11), 5-fluorouracil (eyes, 7), or excision biopsy and cryotherapy (eyes, 10; 6 with adjuvant therapy with interferon 𝛼-2b). Medical treatments were performed either through topical treatment or intralesional injection. The primary outcome measure was the complete resolution of tumors and recurrence rate for each treatment.
Papilloma resolution was significantly faster using the surgical method compared with medical treatment (1 day vs 159 days, P <.001). Although treatment resolution occurred in 100% of participants undergoing surgery compared with 35% of individuals receiving medical treatment (P =.001), 11% of patients treated with surgery experienced a tumor recurrence at 6 months and 22% had a recurrence at 1 year. A total of 0% of participants treated exclusively with medical therapies had a recurrence. This differences, however, failed to achieve statistical significance (P =.52)
“The clinical implication of this study is that while surgical excision has a faster time to resolution, medical therapy may have the advantage of less frequent recurrences,” the study authors note. “Perhaps a combination of medical and surgical treatment would be optimal, and this is a subject for future study.”
Study limitations include a retrospective nature, small sample size, and the lack of standardized treatment regimen.
Sripawadkul W, Theotoka D, Zein M, Galor A, Karp CL. Conjunctival papilloma treatment outcomes: a 12-year-retrospective study. Published online December 5, 2022. doi:10.1038/s41433-022-02329-3