Abstract

DO.24.06

Visual acuity after the transscleral resection of uveal melanoma

Petousis V., Krause L., Wachtlin J., Foerster M. H., Bechrakis N. E.
Department of Ophthalmology, Charité, Campus Benjamin Franklin, Berlin

Objective: Transscleral tumour resection (TTR) facilitates the extraction of large, anteriorly located uveal melanomas. Purpose of our study was to access the visual outcome after this treatment and the factors that affect it, taking into consideration, the risk of tumour recurrence and metastasis.
Methods: The study group consisted of 166 patients (81 women and 85 men, mean age of 49,9±12,89 years), being treated between 1992 and 2005 with a TTR. 13% of the eyes received no adjuvant radiotherapy, while 82% and 5%, respectively, received either a Ru-106 brachytherapy at the same time with the TTR or a proton teletherapy prior to it. The data were retrospectively analyzed.
Results: The preoperative mean best corrected visual acuity (BCVA) was 0,4 and deteriorated directly after the operation, only to rise again after approximately 10 months and stabilize at 0,1 during a 4 year course. Factors affecting this course were the tumour height, the tumour basis diameter, the distance from the macula and the BCVA before the treatment. At 5 years, the tumour recurrence rate was 29 %, the metastatic risk 30% and the enucleation risk 17%.
Conclusions: TTR allowed for most of the patients in our study, to keep the affected eye with a remaining useful vision. At the same time, the was no rising either of the tumor recurrence or the metastatic risk. Tumour resection of uveal melanomas constitutes an alternative therapeutic modality with several advantages in the treatment of large uveal melanomas. Adjuvant irradiation is essential for minimizing the risk of tumour recurrence.

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