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N. Cassoux, S. Cayette, L. Lumbroso-Le Rouic, C. Levy, B. Asselin, R. Dendale, P. Lehoang, L. Desjardins; Endoresection for Large Choroidal Melanoma After Proton Beam: Preliminary Results. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5147.
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to evaluate the benefits of endoresection for large choroidal melanoma after proton beam irradiation in reducing the rate of secondary enucleation.
Monocentric prospective study. Were included patients with large choroidal melanoma of at least 6mm in thickness. Surgery was done 3 months or more after proton beam irradiation. Were excluded patients in witch a primary enucleation was recommended, tumors that invade the optic nerve head or ciliary body, contra indication for general anaesthesia. Endoresection was performed after pars plana vitrectomy followed by a silicon oil tamponade.
since the 1st of January 08, 48 patients mean age 55 year-old (17-81 y-o) were included. Median time between irradiation and surgery was 4.4 months (2-12 m). Mean tumor diameter was 13.9 mm (2.7-19 mm), mean tumor thickness was 8.6 mm (6.3-12.2mm). Before surgery 91.8% of patients presented a retinal detachment. Neovascular glaucome was present for 2 patients. Tumor was removed and retina was reattached in all the patients except for 2 of them. Post operative complications included hyphema in 10.20%, retinal detachment relapse in 6.1%. No neovascular glaucoma, no local recurrence of the tumor, were observed after a mean follow-up of 11 months (2-21 months).
These preliminary results showed that endoresection is a safe procedure after proton beam irradiation and can improve eye retention for the biggest tumors.
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