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Simon F Leicht, Veronika Reiterer, Alexander Muacevic, Paul Foerster, Anselm Kampik, Kirsten Eibl-Lindner; Secondary Glaucoma after Cyberknife Radiotherapy for Uveal Melanoma - Preliminary Analysis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5093.
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Uveal melanoma represents the most common primary intraocular malignancy. For tumor treatment, different modes of radiation are applied such as brachytherapy (ruthenium106 or iodine 125 plaque) or teletherapy with proton therapy or Cyberknife radiotherapy. Cyberknife radiotherapy is administered as a frameless single session outpatient procedure and represents one of the latest available treatment techniques. Data on complications after Cyberknife radiotherapy are unavailable so far and thus we aimed to determine the incidence of secondary glaucoma after treatment, a significant complication regarding life quality and long-term preservation of vision.
We performed a retrospective chart review of 143 consecutive patients with uveal melanoma from our ocular oncology service who had successfully undergone Cyberknife radiotherapy between 2007 und 2013. The follow up period, tumor thickness as determined by standardized ultrasound examination before treatment, incidence of secondary glaucoma and time until onset of secondary glaucoma were determined.
143 patients were included in the study. The follow up period ranged from 2.73 to 85.22 months with a mean of 22.34 months. Tumors had an average thickness of 6.49 mm prior to therapy. Of all patients, 27% (38 of 143 patients) developed secondary glaucoma during the follow up period. The total enucleation rate due to secondary glaucoma was 8% (12 of 143 patients). Otherwise, IOP was controlled effectively by topical and/or Laser treatment. Secondary glaucoma occured at a mean of 21.8 months after Cyberknife radiotherapy ranging from 2.79 to 64.44 months.
Cyberknife radiotherapy allowed for tumor control in all patients included in this retrospective chart review. The incidence of secondary glaucoma was 27% at a mean follow-up time of 21.8 months. Secondary glaucoma is a critical parameter in the long-term assessment for vision preservation in these patients.
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