title: Conservative resection and adjuvant plaque brachytherapy for early-stage conjunctival melanoma.
abstract: BACKGROUND
  To describe the outcome of patients treated by conservative surgical excision followed by adjuvant plaque brachytherapy for early-stage primary or recurrent conjunctival melanoma.
  
  
  METHODS
  Retrospective, non-comparative, interventional case series.
  
  
  METHODS
  We reviewed 19 eyes in 19 consecutive patients presenting with biopsy proven conjunctival melanoma with pathologic stage pT1c or less.
  
  
  METHODS
  Patients with primary or recurrent early-stage conjunctival melanoma were identified and treated using a conservative resection technique (tractional micro-dissection) involving avoidance of deep dissection and modest lateral clearance followed by adjuvant plaque brachytherapy.
  
  
  METHODS
  Local recurrence and ocular complications.
  
  
  RESULTS
  Mean age was 55.2 years and male : female (8:11). Mean follow up was 43.1 months (range 30.1-54.3 months). All patients were treated by conservative resection followed by adjuvant Iodine-125 plaque brachytherapy. The treatment dose was 100 Gy to a depth of 1.5-3.0 mm.
  
  
  RESULTS
  median visual acuity and intraocular pressure were unchanged after surgery. Six patients experienced corneal ulceration in the immediate postoperative period. No patients experienced recurrence at the treatment site or metastases. Three patients experienced new lesions distant from the treatment site.
  
  
  CONCLUSIONS
  Conservative resection and adjuvant plaque brachytherapy is an effective and well-tolerated modality for the management of patients with early-stage conjunctival melanoma.
authors.affiliation: Sydney Eye Hospital and Ocular Oncology Centre, Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Rushmia
authors.initials: R
authors.lastname: Karim
authors.forename: R Max
authors.initials: RM
authors.lastname: Conway
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D003131:Combined Modality Therapy; D003230:Conjunctival Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D010865:Pilot Projects; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes