Abstract
The Collaborative Ocular Melanoma Study (COMS) group randomized trial has established the use of episcleral I125 plaques as an alternative treatment to enucleation for medium sized choroidal malignant melanoma (CMM). The COMS protocol utilizes a dose of 85 Gy to the tumor apex or a minimum 5 mm height, which ever is greater. The optimal prescribed dose to ensure acceptable disease free survival, yet minimize radiation related ocular complications, is uncertain. We have often used doses that are lower than the COMS group trial and have prescribed dose to the tumor apex even when tumors were < 5 mm in height.
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