• Anasua G Kapoor, Vijitha S Vempuluru, Srujana Laghimshetty, Aravind Roy, Savitri Sharma, Dilip K Mishra, Ashik Mohamed, and Swathi Kaliki.
• Hima Bindu Yalamanchili Centre for Eye Cancer, LV Prasad Eye Institute, Vijayawada, India; The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India; The Cornea Institute, L V Prasad Eye Institute, Vijayawada, India; Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, India; Ophthalmic Pathology Laboratory, L V Prasad Eye Institute, Hyderabad, India; and Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India.
• Cornea. 2021 Jul 22.

PurposeThe purpose of this study was to evaluate the incidence, clinical features, microbiology, risk factors, and treatment outcomes in cases of ocular surface squamous neoplasia (OSSN) with coexisting microbial keratitis (MK).MethodsThis was a retrospective case-control study from a cohort of 939 cases with OSSN.ResultsTwenty eyes (2%) with OSSN and MK were included in the study group and 100 age-matched eyes with only OSSN as controls. Most common presentation was a combination of pain, redness, watering, and decreased vision (50%) over a median duration of 14 days. Mean corneal surface involvement by MK was 48% with corneal perforation in 6 cases (30%). Microbiology showed 10 culture positive cases for Gram-positive organisms (n = 5), fungus (n = 4), or mixed infection (n = 1). In the salvaged eyes, MK resolved in 9 eyes (90%) on medical treatment at a mean duration of 30 days and keratoplasty was performed in 1 eye. OSSN treatment included wide excisional biopsy (n = 9/18; 50%), extended enucleation (n = 7/18; 39%), and orbital exenteration in 1. Over a mean follow-up of 12 months, vision salvage was achieved in 7 of 18 (39%) and globe salvage in 10 of 18 (55%). Logistic regression analysis showed the following significant risk factors for MK in OSSN: male sex, human immunodeficiency virus seropositivity, increasing tumor diameter, limbal epicenter, temporal quadrant, noduloulcerative morphology, pigmentation, scleral invasion, keratin, and corneal component of the OSSN lesion.ConclusionsRarely, MK can coexist with OSSN leading to a poor treatment outcome. Male sex, human immunodeficiency virus seropositivity, large limbal pigmented OSSN lesion with keratin and corneal component, noduloulcerative morphology, and scleral invasion were risk factors for this association.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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