Triad for Ocular Surface Bowen Disease: Surgical Excision Adjuvant Topical Mitomycin C and Amniotic Membrane Transplantation in One-Year Outcomes A Case Report

Abstract

 A 52-year-old man with remote HBV positivity presented with a recurrent, circumferential right-eye conjunctival lesion and underwent wide excision with intraoperative 0.02% mitomycin C (MMC)–soaked sponges, amniotic membrane grafting, and subsequent topical MMC 0.02% in alternating-week cycles; histopathology showed squamous cell carcinoma in situ (Bowen’s disease), an entity within the ocular surface squamous neoplasia spectrum managed effectively with surgery and topical chemotherapy to reduce recurrence risk. Early postoperative recovery was favorable, with re-epithelialization under a bandage contact lens, complete amniotic membrane resorption, and later conjunctival autografting to cover temporal bare sclera. No tumor recurrence was observed during short-term follow-up; longer surveillance was curtailed due to death from systemic causes unrelated to the ocular disease. This case aligns with literature supporting adjuvant topical MMC (commonly 0.02–0.04% in cyclic regimens) for conjunctival–corneal intraepithelial neoplasia to achieve high resolution rates while balancing risks such as delayed corneal epithelial erosions and limbal stem cell deficiency.