Eyeworld

DECEMBER 2022 | EYEWORLD | 77 C Contact Gombos: dgombos@mdanderson.org Shields: carolshields@gmail.com What's next for interferon Dr. Shields said when interferon became un- available in the U.S., the International Society of Ocular Oncology and the American Association of Ophthalmic Oncologists and Pathologists met with the American Academy of Ophthalmology to discuss the situation and possible options. "There was talk of a company in China … but the cost was out of control. We need an American company to get interested in making interferon because patients hugely benefited from it," Dr. Shields said. "There is some talk of using alternatives of interferon but there have been no big studies looking at those. There is hope that other types of interferons can be use- ful, but interferon alpha-2b was well tolerated and effective." Dr. Shields said she doesn't want the oph- thalmic community or their patients to worry. "We have 5-FU. 5-FU is very effective. We had one case of a squamous neoplasia sitting over a glaucoma tube shunt. I didn't want to operate near that. We put that patient on 5-FU, it melted away, and she's doing fine," Dr. Shields said. Dan Gombos, MD, past president of the American Association of Ophthalmic Oncolo- gists and Pathologists and current president of the International Society of Ocular Oncology, said that the disappearance of IFNα-2b for ophthalmologists has "significantly impacted" physicians' ability to treat patients. He said that these societies have alerted American and European societies and their colleagues in the field of this issue, but "we haven't been able to change the access to this medication and that's where we stand." Finding a new company to produce IFNα-2b is ideal, but Dr. Gombos said that won't be a quick fix for the current situation. "This is bringing together the ocular on- cology community worldwide because many of us are finding … you can't get the drug; it's as simple as that," Dr. Gombos said. Topical chemotherapy with 5-FU 1% for extensive medial bulbar ocular surface squamous neoplasia A. Before: The leukoplakia (labeled with *) mass is extensive (arrows), occupying limbus to medial eyelid margin, measuring 30 mm in base. B. After: Following 2 months of topical 5-FU, with a 1-month drug holiday between doses, the mass completely regressed, leaving no residua. Source: Carol L. Shields, MD A B

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