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Br J Ophthalmol. 2013 Apr;97(4):471-4. doi: 10.1136/bjophthalmol-2012-302659. Epub 2013 Jan 7.

Whole anterior segment proton beam radiotherapy for diffuse iris melanoma.

Author information

1
Ocular Oncology Service, Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK.

Abstract

AIM:

To report the results of whole anterior segment proton beam radiotherapy (PBR) for diffuse iris melanoma.

METHODS:

Between 2000 and 2011, 12 patients with iris melanoma received PBR to the entire iris and ciliary body.

RESULTS:

Patients had a mean age of 57 years and a median follow-up of 3.5 years (range 1-11.6 years). Tumour iris involvement was 1-4 h in five patients, 5-8 h in four and 9-12 h in three. Angle involvement was 6-8 h in five patients and 9-12 h in seven. The visual acuity (VA) before treatment was 6/5-6/6 in six patients, 6/8-6/9 in three and 6/18-6/38 in three. No tumour recurrence occurred during the follow-up period. Glaucoma treatment was required in 11 of 12 patients. The visual acuity at the last follow-up was 6/5-6/9 in five patients, 6/18-6/24 in three, 6/60-1/60 in two and no light perception in two. Four patients developed varying non-severe degrees of limbal stem cell deficiency, which was treatable with conservative measures.

CONCLUSIONS:

Whole anterior segment PBR is a useful alternative to enucleation for diffuse iris melanoma. Most patients will need treatment for glaucoma and some may require treatment for tear-film instability and/or stem cell failure.

[Indexed for MEDLINE]

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