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British Journal of Ophthalmology
Article . 1998 . Peer-reviewed
Data sources: Crossref
HKU Scholars Hub
Article . 2012
Data sources: HKU Scholars Hub
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Endoresection of choroidal melanoma

Authors: Wong, D; Damato, B; Groenewald, C; McGalliard, J;

Endoresection of choroidal melanoma

Abstract

The results of 52 endoresections for choroidal melanoma are reported.The current technique involves vitrectomy, retinal incision over or peripheral to the tumour, haemostasis by raising intraocular pressure and by moderate hypotensive anaesthesia, choroidal incision around tumour, endoresection with vitrector, endodiathermy to bleeding points and residual tumour, fluid-air exchange to reattach retina, endolaser to achieve retinal adhesion around the coloboma and destroy residual tumour in the sclera, silicone oil injection with removal after 12 weeks, cryotherapy to the sclerotomies, and adjunctive ruthenium plaque radiotherapy in selected cases.Patients receiving primary endoresection had a mean age of 53 years, a mean largest basal tumour diameter of 8.2 mm, and a mean tumour thickness of 3.9 mm. 40 tumours extended to within 2 disc diameters of the optic disc, with 17 involving disc. Follow up ranged from 40 days to 7 years (median 20 months). At the last visit, 90% of eyes were retained, with vision of 6/6-6/12 (two), 6/18-6/36 (three), 6/60 to counting fingers (18), hand movements (nine), and light perception (four). The main complications were retinal detachment in 16 and cataract in 25. Secondary endoresection (11) was performed after plaque radiotherapy (four), photocoagulation (four), trans-scleral local resection (two), and proton beam radiotherapy (one), with retention of the eye in nine cases. By the close of the study, no patients developed definite local tumour recurrence but one died of metastatic disease 41 months postoperatively.Depending on tumour location, endoresection may conserve central vision or temporal field when radiotherapy would be expected to cause optic neuropathy. Longer follow up is necessary to establish the efficacy of tumour control.

Country
China (People's Republic of)
Keywords

Adult, Male, Reoperation, Ophthalmologic Surgical Procedures - Adverse Effects - Methods, Visual Acuity, Retinal Detachment - Etiology, Ophthalmologic Surgical Procedures, 80 And Over, Cataract, Eye Enucleation, Silicone Oils - Adverse Effects, 616, Humans, Silicone Oils, Choroid Neoplasms - Surgery, Neoplasm Recurrence, Local - Surgery, Melanoma, Melanoma - Surgery, Aged, Aged, 80 and over, Choroid Neoplasms, Retinal Detachment, Middle Aged, Aged, 80 And Over, Neoplasm Recurrence, Treatment Outcome, Local - Surgery, Cataract - Etiology, Female, Neoplasm Recurrence, Local, Follow-Up Studies

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    popularity
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
158
Top 10%
Top 1%
Top 10%
bronze
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