Long-term Follow-up after Transpupillary Thermotherapy (TTT) for Uveal Melanomas of the Posterior Pole
Langmann G., Wenzl E., Wackernagl W., Müllner K.
University Eye Hospital Graz
Purpose: An increasing number of orbital recurrances have been reported, the aim of our paper is to demonstrate our results after a maximum follow up of 7 years and 10 months.
Method: Among 16 patients with a median age of 63,5 years (range 40 83 years) uveal melanoms developed in 18 eyes. 10 tumors were classified as small (with a maximum prominence of 3 mm), 8 as medium sized (with a maximum prominence in A scan echography of 5,6 mm). 5 melanomas were juxtapapillary, 6 maculary (juxtamaculary) and 7 located in the midperiphery of the fundus.
Results: After a minimum follow up of 24 months (maximum 7 years and 10 months) in 7 tumors a complete regression (scar formation) could be achieved, in 6 a partiell regression ( with a maximum rest prominence of 2,9 mm). In 3 patients a recurrance at the margin of the previously treated tumor occured treated either by TTT or a Ruthenium 106 plaque, in another 2 recurrances enucleation had to be performed. In non of the cases an orbital recurrance occured. As severe side effects vitreous haemorrhage developed in 2 patients, severe maculopathy in 5 patients (3 macular pucker) and in one a rhegmatogenous detachment.
Conclusions: To prevent recurrances an adaequate technique (optimum energy of the diode laser with a slight whitening after 45 sec ) and an appropriate selection of patients is mandatory. in our opinion (no tumors higher t
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