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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Mayer, CF; Langmann, G; Wackernagel, W; Schneider, M; Wedrich, A.
Bulbuserhalt und Funktion nach Endoresektion und Gamma-Knife Radiochirurgie uvealer Melanome
Spektrum der Augenheilkunde. 2009; 23: 347-352. Doi: 10.1007/s00717-009-0354-5
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Führende Autor*innen der Med Uni Graz

Mayer-Xanthaki Christoph Fidel

Co-Autor*innen der Med Uni Graz

Langmann Gerald

Schneider Mona Regina

Wackernagel Werner

Wedrich Andreas

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Abstract:

Eyes with uveal melanoma sometimes need surgical intervention cause of radiation induced retinal complications. We report visual outcome, complications and globe preservation rates. 13 patients (10 male, 3 female) with a mean age of 64 years (range 42-88 years) were treated by single fraction Gamma Knife radiosurgery in 12 patients, two had previous thermotherapy and in one patient Ruthenium 106 brachytherapy was administered. All were subsequently endoresected by pars plana vitrectomy and silicone oil tamponade. In six patients period was less than six months (median, 2 months) and in seven patients period was more than six months (median, 19 months). Mean tumor base was 12.5 mm (range 8.3-20 mm), mean tumor prominence 9 mm (4.4-16.5 mm). Visual acuity was LP-20/400 in five, 20/200-20/40 in seven and 20/20 in one patient before radiation. Globe preservation was achieved in 12/13 (92 %), in 13/13 total tumor regression without any recurrence was achieved. Visual acuity after surgery was NLP in five patients, in seven patients LP-20/400 and in one patient 20/200. No clinically significant difference in visual acuity was seen in the group with endoresection earlier or later than six months. Seven additional operations after primary vitreoretinal surgery had to be performed (four vitrectomies, one enucleation and one lavage of the anterior chamber). Two patients developed distant metastases. Our data show that combined vitreoretinal surgery and endoresection after radiation are an acceptable management option for preservation of the globe and the residual visual function in uveal melanomas with retinal detachment or vitreous bleeding, yet visual function is determined by radiation induced side effects and the duration of the retinal detachment.

Find related publications in this database (Keywords)

Endoresection

Gamma Knife

uveal melanoma

Ruthenium 106 brachytherapy

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