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Exoresection via partial lamellar sclerouvectomy approach for uveal tumors: A successful performance by a novice surgeon.

Kurt RA, Gündüz K - Clin Ophthalmol (2010)

Bottom Line: Exoresection seems to be an effective treatment option in selected cases of iridociliary and ciliary body tumors.Novice surgeons with limited training in PLSU should not discourage themselves from doing this type of surgery.Several postoperative complications inevitably occur and require frequent patient monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

ABSTRACT

Purpose: To evaluate the results and complications of exoresection via a partial lamellar sclerouvectomy (PLSU) procedure for uveal tumors performed by a novice surgeon without help from an experienced surgeon.

Methods: Medical records of 22 patients who underwent exoresection for uveal tumors between February 1999 and January 2009 were evaluated retrospectively. Exoresection was considered for tumors with their epicenter in the iris or in the ciliary body.

Results: Twenty-two patients with a mean age of 45.9 years (range: 19-72 years) were included in this study. The histopathologic diagnosis was uveal malignant melanoma in 16 patients, iridociliary nevus in 2 patients, iris nevus in 2 patients, and iridociliary melanocytoma in 2 patients. Postoperative complications included cataract in 11 patients (50%), scleral thinning in 4 patients (18%), vitreous hemorrhage in 2 patients (9%), hyphema in 2 patients (9%), secondary glaucoma in 2 patients (9%), iridodialysis in 1 patient (4.5%), bullous keratopathy in 1 patient (4.5%), and posterior synechiae in 1 patient (4.5%). At a mean follow-up of 40.1 months (range: 1-98 months), there were no recurrences or metastatic events.

Conclusions: Exoresection seems to be an effective treatment option in selected cases of iridociliary and ciliary body tumors. Novice surgeons with limited training in PLSU should not discourage themselves from doing this type of surgery. Several postoperative complications inevitably occur and require frequent patient monitoring.

No MeSH data available.


Related in: MedlinePlus

One month after exoresection, plaque radiotherapy with a 25 mm Ru-106 plaque was applied to decrease the risk of postoperative recurrence.
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f2c-opth-4-059: One month after exoresection, plaque radiotherapy with a 25 mm Ru-106 plaque was applied to decrease the risk of postoperative recurrence.

Mentions: Postoperative complications included cataract in 11 patients (50%) that was not present before surgery, scleral thinning in 4 patients (18%) (Figure 3), nonresolving (>8 weeks) vitreous hemorrhage in 2 patients (9%), secondary glaucoma in 2 patients (9%), hyphema in one patient (4.5%), iridodialysis in 1 patient (4.5%), bullous keratopathy in 1 patient (4.5%), and posterior synechiae in 1 patient (4.5%). All patients with cataract underwent phacoemulsification surgery with intraocular lens implantation (IOL) (Figure 1c). In one case (4.5%), nucleus drop during phacoemulsification surgery occurred, necessitating vitrectomy and nuclear fragment removal via vitrectomy and phacofragmentation. One patient developed bullous keratopathy after PLSU and subsequent phacoemulsification surgery. Of the four patients with scleral thinning, three remained stable and one underwent patch graft reinforcement because of bulging of the anterior uvea. Of the two patients with vitreous hemorrhage, one underwent vitrectomy. The other opted to wait, and the hemorrhage cleared partially in the second year after surgery. Secondary glaucoma was due to hyphema in one patient, and this patient underwent trabeculectomy. Both patients with secondary glaucoma needed antiglaucoma drops for IOP control. After PLSU, adjunctive Ru-106 plaque radiotherapy was performed in five cases with ciliary, ciliochoroidal, and iridociliochoroidal melanoma (Figure 2c).


Exoresection via partial lamellar sclerouvectomy approach for uveal tumors: A successful performance by a novice surgeon.

Kurt RA, Gündüz K - Clin Ophthalmol (2010)

One month after exoresection, plaque radiotherapy with a 25 mm Ru-106 plaque was applied to decrease the risk of postoperative recurrence.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2819770&req=5

f2c-opth-4-059: One month after exoresection, plaque radiotherapy with a 25 mm Ru-106 plaque was applied to decrease the risk of postoperative recurrence.
Mentions: Postoperative complications included cataract in 11 patients (50%) that was not present before surgery, scleral thinning in 4 patients (18%) (Figure 3), nonresolving (>8 weeks) vitreous hemorrhage in 2 patients (9%), secondary glaucoma in 2 patients (9%), hyphema in one patient (4.5%), iridodialysis in 1 patient (4.5%), bullous keratopathy in 1 patient (4.5%), and posterior synechiae in 1 patient (4.5%). All patients with cataract underwent phacoemulsification surgery with intraocular lens implantation (IOL) (Figure 1c). In one case (4.5%), nucleus drop during phacoemulsification surgery occurred, necessitating vitrectomy and nuclear fragment removal via vitrectomy and phacofragmentation. One patient developed bullous keratopathy after PLSU and subsequent phacoemulsification surgery. Of the four patients with scleral thinning, three remained stable and one underwent patch graft reinforcement because of bulging of the anterior uvea. Of the two patients with vitreous hemorrhage, one underwent vitrectomy. The other opted to wait, and the hemorrhage cleared partially in the second year after surgery. Secondary glaucoma was due to hyphema in one patient, and this patient underwent trabeculectomy. Both patients with secondary glaucoma needed antiglaucoma drops for IOP control. After PLSU, adjunctive Ru-106 plaque radiotherapy was performed in five cases with ciliary, ciliochoroidal, and iridociliochoroidal melanoma (Figure 2c).

Bottom Line: Exoresection seems to be an effective treatment option in selected cases of iridociliary and ciliary body tumors.Novice surgeons with limited training in PLSU should not discourage themselves from doing this type of surgery.Several postoperative complications inevitably occur and require frequent patient monitoring.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

ABSTRACT

Purpose: To evaluate the results and complications of exoresection via a partial lamellar sclerouvectomy (PLSU) procedure for uveal tumors performed by a novice surgeon without help from an experienced surgeon.

Methods: Medical records of 22 patients who underwent exoresection for uveal tumors between February 1999 and January 2009 were evaluated retrospectively. Exoresection was considered for tumors with their epicenter in the iris or in the ciliary body.

Results: Twenty-two patients with a mean age of 45.9 years (range: 19-72 years) were included in this study. The histopathologic diagnosis was uveal malignant melanoma in 16 patients, iridociliary nevus in 2 patients, iris nevus in 2 patients, and iridociliary melanocytoma in 2 patients. Postoperative complications included cataract in 11 patients (50%), scleral thinning in 4 patients (18%), vitreous hemorrhage in 2 patients (9%), hyphema in 2 patients (9%), secondary glaucoma in 2 patients (9%), iridodialysis in 1 patient (4.5%), bullous keratopathy in 1 patient (4.5%), and posterior synechiae in 1 patient (4.5%). At a mean follow-up of 40.1 months (range: 1-98 months), there were no recurrences or metastatic events.

Conclusions: Exoresection seems to be an effective treatment option in selected cases of iridociliary and ciliary body tumors. Novice surgeons with limited training in PLSU should not discourage themselves from doing this type of surgery. Several postoperative complications inevitably occur and require frequent patient monitoring.

No MeSH data available.


Related in: MedlinePlus