Document Detail


Pars plana vitrectomy in eyes containing a treated posterior uveal melanoma.
MedLine Citation:
PMID:  12967800     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the safety of pars plana vitrectomy in eyes containing a treated posterior uveal melanoma. DESIGN: Interventional case series. METHODS: Retrospective case series of patients with posterior uveal melanoma who underwent pars plana vitrectomy. Complications, vitreous cytology, local tumor control, and metastasis were assessed. RESULTS: Nine patients met study criteria. Tumors were treated with (125)I plaque radiotherapy (seven patients) or transpupillary thermotherapy (two patients). Vitrectomy was performed for vitreous hemorrhage (five patients), macular pucker (two patients), macular hole (one patient), and rhegmatogenous retinal detachment (one patient). Vitrectomy was performed at a mean of 24.7 months (range, 7-47 months) after melanoma treatment. Dispersion of tumor cells at vitrectomy was not observed in any patients. Melanoma cells were detected in the vitreous aspirate in one of seven cases examined cytologically. This patient had intratumoral and vitreous hemorrhage before plaque radiotherapy, underwent combined vitrectomy/cataract extraction, and developed intraocular tumor dissemination 56 months after vitrectomy. No other patients developed intraocular tumor dissemination. At mean follow-up of 24 months (range, 3-63 months) after vitrectomy, none of the nine patients developed systemic metastasis. CONCLUSIONS: Pars plana vitrectomy rarely may lead to intraocular tumor dissemination, although the risk of this complication is probably low if the tumor has been treated and has responded to therapy before vitrectomy. Vitrectomy should be approached with caution if a vitreous hemorrhage is present, especially if the hemorrhage occurred before tumor treatment, as this may seed tumor cells into the vitreous cavity.
Authors:
William J Foster; J William Harbour; Nancy M Holekamp; Gaurav K Shah; Matthew A Thomas
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of ophthalmology     Volume:  136     ISSN:  0002-9394     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-11     Completed Date:  2003-09-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  471-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, and Barnes Retina Institute, St. Louis, Missouri 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brachytherapy
Female
Humans
Hyperthermia, Induced
Male
Melanoma / complications,  therapy*
Middle Aged
Neoplasm Metastasis
Retinal Diseases / complications,  surgery*
Retrospective Studies
Safety
Uveal Neoplasms / complications,  therapy*
Vitrectomy*
Vitreous Hemorrhage / complications,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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