3. Do not violate Bowman's membrane
If opting for surgery, be careful not to violate Bowman’s membrane, which is a natural barrier against the tumor spreading in the cornea.
4. Use cryotherapy as an adjuvant
It is clear from the literature that not applying cryotherapy at the time of the initial surgery increases the risk of tumor recurrence.
For conjunctival melanoma, lack of cryotherapy also increases the risks of metastasis and death.
5. Reconstruct the ocular surface with amniotic membrane
“I’m a big fan of amniotic membrane,” Dr. Colby said. “You can take more uninvolved tissue around the tumor and still have a wonderful outcome.”
6. Treat the entire patient
“I’ve treated many skin cancers just by looking at the patient before I sit down and turn the lights out,” she said. Encourage patients with ocular surface tumors to see a dermatologist for a skin evaluation
7. Consider new technology to help with diagnoses
Dr. Colby cited the work of Carol Karp, MD, of Miami, which has shown that high-resolution anterior segment OCT can help distinguish squamous lesions from amelanotic melanoma. She also praised Dr. Karp’s published reports in the area of ocular surface tumors and interferon.