title: Incidence and indications for pars plana vitrectomy following the treatment of posterior uveal melanomas in Scotland.
abstract: BACKGROUND
  Globe-sparing treatments such as plaque brachytherapy, local or endoresection, and proton beam therapy (PBT) are the treatments of choice for posterior uveal melanoma. However, both early and late complications can arise from these techniques, including vitreous haemorrhage (VH) and retinal detachment (RD). Choroidal melanomas in Scotland are managed by a single unit, the Scottish Ocular Oncology Service (SOOS).
  
  
  METHODS
  Indications and outcomes from surgery were analysed for patients undergoing vitrectomy following treatment for uveal melanoma in the SOOS between 1998 and 2013.
  
  
  RESULTS
  Seventeen from 715 cases (2.4%) required vitrectomy, of which 8/445 (1.8%) followed plaque brachytherapy, 7/43 (16.3%) combined local resection and brachytherapy, and 2/227 (0.9%) PBT. Case notes were reviewed for 16/17 cases, with surgery indicated for VH in 10 (63%), RD in 5 (31%), and combined VH/RD in 1 (6%). The median interval from initial tumour treatment to vitrectomy was 5.8 months (range 10 days to 8.8 years). Ten (63%) required early vitrectomy (within 6 months), of which the majority (70%) followed combined resection/brachytherapy. Six (37%) required late vitrectomy (after 6 months), of which all were non-clearing VH following plaque brachytherapy, with proliferative retinopathy in 4/6 (67%), and tumour recurrence in 2/6 (33%). Overall vision improved in 8 eyes (50%), remained the same in 2 (12.5%), and deteriorated in 6 (37.5%).
  
  
  CONCLUSIONS
  Early vitrectomy was most commonly indicated for RD following local resection, and late vitrectomy for VH due to radiation retinopathy. The majority of patients undergoing vitrectomy gained or maintained vision.
authors: Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
authors: S N
authors: SN
authors: Chia
authors: Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
authors: H B
authors: HB
authors: Smith
authors: Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
authors: H M
authors: HM
authors: Hammer
authors: Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
authors: E G
authors: EG
authors: Kemp
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D011183:Postoperative Complications; D061766:Proton Therapy; D012163:Retinal Detachment / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D014604:Uveal Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000706:statistics & numerical data*; D057586:Vitreoretinal Surgery; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D055815:Young Adult; D000098943:Uveal Melanoma
chemical_list: D012429:Ruthenium Radioisotopes