Abstract
<br>Nodular corneal invasion in xeroderma pigmentosum is rare. The depth of clinical involvement can be deceptive. Anterior segment optical coherence tomography/ultrasound biomicroscopy can aid in surgical planning. We reviewed the clinical features, surgical details and long-term outcomes of three patients who underwent superficial keratectomy, lamellar keratoplasty, and penetrating keratoplasty for invasive corneal neoplasia. The histopathology revealed squamous cell carcinoma in all three eyes. No recurrence was noted over a minimum follow-up of 4 years. Early surgery is recommended in view of the risk of deeper penetration. Besides surgery, options include plaque therapy. Comorbid conditions are best addressed sequentially, and long-term follow-up is mandatory.<br>
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