ABSTRACT
Purpose: to determine the long-term visual and mortality outcomes of Endoresection for treatment of malignant posterior choroidal melanoma
Methods: this before and after clinical trial included 20 eyes of 20 patients with a diagnosis of posterior choroidal melanoma confirmed by indirect ophthalmoscopy and A and B ultrasonography. All tumors were medium sized according to measures of Collaborated Ocular Melanoma Study and no one had extraocular metastases. After obtaining informed consent, the eyes underwent vitrectomy and Endoresection of the tumors. Characteristics of the patients and tumors, visual acuity before and after surgery, intraoperative and postoperative complications, and enucleation rates were recorded. Patients were followed for 22 to 108 months [mean: 67.4 +/- 36.1]
Results: of 20 patients, 13 [65%] were male. Mean age was 47.1 +/- 16 years. Overall, 5 [25%] eyes were enucleated including 2 eyes [10%] due to severe intraoperative bleeding, 1 eye [5%] due to recurrence of intraocular melanoma, 1 eye [5%] because of a new focus of the tumor, and 1 eye [5%] secondary to intolerable pain. Final visual acuity of 15 saved eyes was 201200 in one eye [6.7%], counting fingers in 8 eyes [52.3%], hand motion in 3 eyes [20%], and no light perception in 3 eyes [15%]
Conclusion: endoresection of posterior choroidal melanoma is a reasonable globe saving treatment modality. Distant metastasis of choroidal melanoma is an infrequent result of this procedure