Open AccessJournal Article
Eye-wall resection.
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TL;DR: Survition did not appear to be compromised with eye-wall resection, and in very thick melanomas located more posteriorly, ocular retention and visual results appeared to be better than that attained with radiation alone.
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Abstract: PURPOSE: To review the ocular retention rates, visual results, and metastases in uveal tumors managed with eye-wall resection techniques. METHODS: This was a retrospective analysis of uveal tumors selected for eye-wall resection with the surgical procedures performed by a single surgeon. All enucleation specimens were reviewed by one author. Both parametric and non-parametric analysis of data was performed. RESULTS: A total of 132 eyes were scheduled for eye-wall resection surgery. Mean patient age was 52 years (range, 11 to 86 years). Tumors involved the iris alone in 17 cases, the iris-ciliary body in 53, the ciliary body alone in 16, and the choroid (ciliochoroidal, iris-ciliary body-choroid, or choroid) in 46 cases. A total of 114 eyes harbored melanomas; tumors located more posteriorly were more likely to have epithelioid cells (P < .05). Mean follow-up was 6 years. Mean number of clock hours in iris and iris-ciliary body tumors was 3.5. In tumors that involved the choroid, the mean largest diameter was 12.6 mm and the mean thickness was 8.2 mm. Ninety-three (70%) of 132 eyes were retained. Histologic assessment of surgical margins did not correlate with either evidence of tumor in enucleated eyes or metastatic disease. Surgical margins of tumors located more anteriorly were more likely to be clear on histologic evaluation (P < .05). Approximately 56% of retained eyes had a final visual acuity of 20/40 or better; visual results were significantly better in tumors located more anteriorly (P < .05). All retained eyes with iris tumors had a final visual acuity of 20/40 or better. In tumors that involved the choroid, 8 of 25 retained eyes kept visual acuity of 20/40 or better. Metastases developed in 8 patients; all metastatic events developed in patients with tumors that involved the choroid, and 7 of 8 were mixed cell melanomas. CONCLUSIONS: Seventy percent of eyes were retained, and 56% of these had a final visual acuity of 20/40 or better. Only 7% of patients with uveal melanoma developed metastatic disease (mean follow-up, 6 years). Survival did not appear to be compromised with eye-wall resection, and in very thick melanomas located more posteriorly, ocular retention and visual results appeared to be better than that attained with radiation alone.
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TL;DR: Charged-particle external-beam irradiation may be more applicable and have less ocular morbidity than either radioactive plaques or photocoagulation.
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Block excision of cystic and diffuse epithelial ingrowth of the anterior chamber. Report on 32 consecutive patients.
TL;DR: From 1980 to 1990, 32 consecutive patients with progressive cystic or diffuse epithelial ingrowth of the anterior chamber were treated successfully with block excision, indicating that block excison currently may be the treatment of choice for cystic and diffuse sheetlike epithelialIngrowth ofThe anterior chamber.
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Ten Years Experience with Eye Wall Resection for Uveal Malignant Melanomas
TL;DR: Thirty-four patients underwent eye wall resection for choroidal malignant melanoma over a period of more than ten years, and 11 eyes were later enucleated for complications and two patients died from unrelated causes.
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Predictive factors of visual outcome after local resection of choroidal melanoma.
B E Damato,James Paul,W S Foulds +2 more
TL;DR: In patients with choroidal melanoma, conservation of the eye and vision can be achieved by local resection, especially if the tumour is located nasally and does not extend close to the disc or fovea.
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