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Nika Bagheri, Jorge Fortun, Justin H Townsend, Harry W Flynn, J. William Harbour; Surgical approach and outcomes of pars plana vitrectomy in eyes harboring a treated posterior uveal melanoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5017.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcomes of patients undergoing pars plana vitrectomy in eyes harboring a posterior uveal melanoma (PUM).
Retrospective, nonrandomized, interventional case series of patients with treated PUM who underwent pars plana vitrectomy (PPV) at the Bascom Palmer Eye Institute between 08/2012 and 12/2015. The surgical technique included small gauge vitrectomy, conjunctival peritomy at sclerotomy sites, valved trocars, avoidance of laser photocoagulation directly around the tumor (to avoid atrophic slit tears), silicone oil tamponade (in cases with exudative retinal detachment), and cryotherapy to sclerotomy sites, which were then sutured with 8-0 vicryl. Baseline demographic and clinical data were recorded. Primary outcome data included local tumor control, retinal attachment status, metastasis and surgical complications.
Ten patients were included, nine of whom were treated with 125-I plaque radiotherapy and one with proton beam radiotherapy. The indication for PPV was non-clearing vitreous hemorrhage in 4 eyes, exudative retinal detachment in 4 eyes, and increasing pigment dispersion in 2 eyes. Vitrectomy was performed at a mean of 12.9 months (range 1-48 months) after primary treatment for PUM. At a mean follow-up of 23.7 months (range 4-42 months) after vitrectomy, there were no cases of local or regional recurrence, retinal re-deatchment, surgical complications or systemic metastases.
Our approach to PPV in eyes harboring a treated PUM, which is aimed at minimizing the risk of local tumor recurrence at the sclerotomy sites or elsewhere, appears to be safe and effective.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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