Enucleation versus preservation of blind eyes following plaque radiotherapy for choroidal melanoma.
BACKGROUND
Currently available information about patients with posterior uveal melanoma treated by plaque radiotherapy is insufficient to determine what to do about eyes that become blind as a consequence of the tumour and its treatment. Should they be enucleated, or is ocular preservation just as good in terms of survival?


METHODS
We performed a retrospective survival analysis of secondary enucleation versus ocular preservation in patients with a posterior uveal melanoma treated by plaque radiotherapy whose irradiated eye became completely blind following that treatment. Of the 79 patients who fulfilled defined inclusion criteria, 25 underwent secondary enucleation of the blind eye, and 54 retained their irradiated blind eye.


RESULTS
Most of the baseline demographic and tumour-related variables evaluated were similarly distributed between the subgroups. The 5-year, 10-year and 15-year all-cause death rates in the secondary enucleation subgroup were 24.7%, 51.5% and 52.0% respectively, and those in the ocular preservation subgroup were 7.4%, 32.9% and 48.1% respectively. In spite of the apparent slight difference between the curves, the difference was not statistically significant (p = 0.41, Mantel-Haenszel test).


CONCLUSIONS
Although a retrospective study of this type has several limitations, our results suggest that secondary enucleation is not likely to substantially improve survival of patients whose irradiated eye becomes totally blind following plaque radiotherapy for choroidal or ciliochoroidal melanoma.
Oncology Service, Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0527, USA. augsbujj@uc.edu
James J
JJ
Augsburger
Lucie
L
Khouri
Athanasios
A
Roumeliotis
Robert C
RC
Kersten
Dwight R
DR
Kulwin
Susan
S
Schneider
D001766:Blindness / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D002830:Choroid Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate