Vitreoretinal Complications after Endoresection for Large Uveal Melanomas
Schilling H.1, Talies S.1, Horstmann G. H.2, Bornfeld N.1
1Universitäts-Augenklinik Essen; 2Gammaknife-Zentrum Krefeld
Purpose: The endoresection of large uveal melanomas in combination with pretreatment with stereotactic gamma-knife radiosurgery represents an invasive operative procedure that is associated with large retinotomies and extended areas of scarification.
Method: Between march 2000 and november 2002 forty-seven patients with large uveal melanomas underwent stereotactic radiosurgery (Leksell Gamma-knife) before endoresection of the tumor via a standard 3-port-vitrectomy including lasercoagulation and tamponade with silicone oil. The average height of the tumors was 9.5 mm. In this retrospective case analysis the incidence and nature of vitreoretinal complications, the amount of secondary operations and the functional results were observed.
Results: The average follow-up time was 12.4 months (SDEV: 8.9 months). In 41 cases (87.2 %) the eyes could be retained with a median visual acuity of 0.25 with a VA of 0.1 or better in 39 cases (83 %) and 0.3 or better in 9 cases (19.1 %). Extended bleedings between the silicone interface, in the anterior chamber, or in the subretinal space represented the most common complication related with the operation in 12 cases (25.2%). Proliferative vitreoretinopathy was observed in 4 cases (8.5 %). In 13 patients (27.7 %) additional major surgery was required via a pars plana appr
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