title: Long-term outcome of primary endoresection of choroidal melanoma.
abstract: BACKGROUND
  Endoresection of choroidal melanoma may offer the best hope of conserving vision in some patients but is controversial because of concerns regarding iatrogenic tumour dissemination.
  
  
  METHODS
  Retrospective, non-randomised study of consecutive patients who underwent endoresection for choroidal melanoma at the Liverpool Ocular Oncology Centre between 1996 and 2010.
  
  
  RESULTS
  The study included 71 patients with a mean age of 58.7 years. The tumour extended within 2 disc diameters of the optic disc in 46 (65%) eyes, involving the disc in 24 (34%) eyes. The mean largest basal tumour diameter and tumour thickness were 9.5 mm and 4.4 mm, respectively. The median follow-up was 4.1 years. The visual acuity at the latest follow-up was better than 6/30 in 31% eyes. The main causes of visual loss were foveal excision, rhegmatogenous retinal detachment (RD) and proliferative vitreo-retinopathy (PVR). Local recurrence developed in two patients (3%), who were treated by enucleation and proton beam radiotherapy, respectively. RD occurred in 16 cases (22%). Three (4%) eyes were enucleated, two because of PVR and one because of local tumour recurrence. Five patients died of metastatic disease.
  
  
  CONCLUSIONS
  Endoresection achieved high rates of local tumour control. This operation would seem to be a useful alternative to radiotherapy as a means of conserving vision in eyes with juxtapapillary melanoma.
authors.affiliation: St Paul's Eye Unit, Liverpool Ocular Oncology Centre, , Liverpool, UK.
authors.forename: Lazaros
authors.initials: L
authors.lastname: Konstantinidis
authors.forename: Carl
authors.initials: C
authors.lastname: Groenewald
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Coupland
authors.forename: Bertil
authors.initials: B
authors.lastname: Damato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009898:Optic Disk / Q000473:pathology; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity; D055815:Young Adult
keywords: Choroid; Neoplasia; Treatment Surgery