Long-term surgical outcome of posterior choroidal melanoma treated by endoresection.
OBJECTIVE
To report the visual acuity, enucleation rates, and initial mortality after transvitreal endoresection of posterior uveal melanoma.


METHODS
Twenty consecutive patients with medium-sized posterior choroidal melanomas were treated. Vitrectomy was performed, followed by posterior hyaloid dissection, retinotomy, melanoma removal with a vitrectomy probe, retinal reattachment with perfluorocarbon liquid, and silicone oil or gas exchange.


RESULTS
Twenty patients (13 men [65%] and 7 women [35%]) were included in the study. The mean patient age +/- SD was 47.1 +/- 16 years (range, 22-70 years). Tumor thickness and tumor diameter ranged from 5.5 mm to 11 mm and 8.0 mm to 15.7 mm, respectively. Preoperative visual acuity ranged from hand motion to 20/40, and postoperative visual acuity ranged from no light perception to 20/30. Two eyes (10%) were enucleated during tumor resection due to severe bleeding. Enucleation was performed on 3 eyes (15%) during follow-up due to tumor recurrence at the edge of surgical coloboma in 1 patient, new focus of tumor in another sector distant from surgical coloboma in 1 patient, and painful blind eye in 1 patient. Fifteen eyes (75%) were saved. One patient (5%) died of metastasis to the liver. The mean follow-up period +/- SD was 89.55 +/- 38.4 months (range, 24-132 months.


CONCLUSIONS
These data suggest that transvitreal endoresection of posterior uveal melanoma is an acceptable management option to conserve the globe and functional vision in selected patients. Distant metastasis is an infrequent event in this modality of treatment.
Karkhaneh
Reza
R
Department of Retina and Vitreous, Farabi Eye Hospital, Eye Research Centre, Tehran University of Medical Sciences, Tehran, Iran. karkhane@sina.tums.ac.ir
Chams
Hormoz
H
Amoli
Fahimeh Asadi
FA
Riazi-Esfahani
Mohammad
M
Ahmadabadi
Mehdi Nili
MN
Mansouri
Mohammad Reza
MR
Nouri
Keramat
K
Karkhaneh
Akbar
A
D000328:Adult; D000368:Aged; D002830:Choroid Neoplasms / Q000401:mortality / Q000601:surgery*; D015353:Eye Enucleation; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D012827:Silicone Oils / Q000008:administration & dosage; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
D012827:Silicone Oils; D013459:Sulfur Hexafluoride