title: Trabeculectomy in patients with uveal melanoma after proton beam therapy.
abstract: BACKGROUND
  Retrospective evaluation of intraocular pressure, use of topical and systemic anti-glaucoma medication, secondary complications, local tumor control and survival in patients treated with trabeculectomy for the regulation of the intraocular pressure (IOP) after proton beam therapy for uveal melanoma.
  
  
  METHODS
  In this retrospective clinical case series we evaluated the follow-up of 15 patients receiving a trabeculectomy as surgical treatment if the IOP could not be lowered adequately by medications or laser surgery. All patients had received proton beam therapy for uveal melanoma at the Helmholtz-Zentrum Berlin between 1998 and 2010.
  
  
  RESULTS
  The median IOP decreased significantly from 35 mmHg ± 8.8 before TE to 16 mmHg ± 8.2 (=52.3 %) six months after TE (Wilcoxon-Mann-Whitney-U Test, p<0.01). None of the patients needed any glaucoma medication six months after trabeculectomy. Two patients developed local recurrence during follow-up, which were independent of the trabeculectomy. One patient had to be enucleated due to intractable pain and suspected remaining tumor activity. One patient died due to metastasis.
  
  
  CONCLUSIONS
  Trabeculectomy is an option in intractable glaucoma in patients with uveal melanoma after proton beam therapy in single cases. Secondary interventions are common. Inoculation metastases are possible. Secure local tumor control must be a prerequisite for filtrating operations.
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany. aline-isabel.riechardt@charite.de.
authors.forename: Aline I
authors.initials: AI
authors.lastname: Riechardt
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.|BerlinProtonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany.
authors.forename: Dino
authors.initials: D
authors.lastname: Cordini
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.
authors.forename: Matus
authors.initials: M
authors.lastname: Rehak
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Hager
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.
authors.forename: Ira
authors.initials: I
authors.lastname: Seibel
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Böker
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.
authors.forename: Enken
authors.initials: E
authors.lastname: Gundlach
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.|BerlinProtonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Heufelder
authors.affiliation: Augenklinik/Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany.
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Joussen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008545:Melanoma / Q000150:complications / Q000175:diagnosis / Q000532:radiotherapy*; D008875:Middle Aged; D061766:Proton Therapy / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000532:radiotherapy*; D000098943:Uveal Melanoma
keywords: Proton beam therapy; Secondary glaucoma; Trabeculectomy; Uveal melanoma