title: Safety of pars plana vitrectomy in eyes with plaque-irradiated posterior uveal melanoma.
abstract: OBJECTIVE
  To determine the long-term safety of pars plana vitrectomy (PPV) in eyes with plaque-irradiated posterior uveal melanoma.
  
  
  METHODS
  In this retrospective case series, patients with plaque-irradiated posterior uveal melanoma subsequently underwent PPV for vitreous hemorrhage. The main outcome measures are the rates of intraocular melanoma dissemination, extrascleral extension of melanoma, local melanoma recurrence, and systemic melanoma metastasis after PPV.
  
  
  RESULTS
  Forty-seven eyes of 47 patients underwent PPV for vitreous hemorrhage after iodine 125-labeled plaque radiotherapy for choroidal melanoma. The mean interval between the onset of vitreous hemorrhage and PPV was 13 (median, 10; range, 0-52) months. The mean time from PPV to last follow-up was 5 (range, 0.5-16) years. There were no cases of intraocular melanoma dissemination or extrascleral extension of melanoma. One patient (2%) developed local choroidal melanoma recurrence (2 years after PPV and 5 years after initial plaque radiotherapy) and was successfully managed with transpupillary thermotherapy. Systemic melanoma metastasis occurred in 4 patients (9%) during a mean interval of 5 years after plaque radiotherapy. During follow-up, 43 patients (91%) were alive without systemic metastasis and 4 patients (9%) were alive with metastasis.
  
  
  CONCLUSIONS
  Management of vitreous hemorrhage by PPV in eyes with previously irradiated uveal melanoma appears to be safe and without increased risk for intraocular, local, orbital, or systemic dissemination of the tumor.
authors.affiliation: Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, 840 Walnut St, Ste 1440, Philadelphia, PA 19107, USA.
authors.forename: Alok S
authors.initials: AS
authors.lastname: Bansal
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Bianciotto
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Maguire
authors.forename: Carl D
authors.initials: CD
authors.lastname: Regillo
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002648:Child; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014463:Ultrasonography; D014821:Vitrectomy / Q000009:adverse effects; D014823:Vitreous Hemorrhage / Q000601:surgery*; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes