Prevention of neovascular glaucoma by endoresection of the uveal melanoma scar after proton beam therapy

Abstract

AbstractThe conservative treatment of uveal melanoma by proton beau or plaque irradiation can induce severe side effects such as exudative retinal detachment, hard exudates, neovascular glaucoma. Part of these complications is not due to the irradiation itself but to a tumor necrosis. The scar releases factors not fully discovered (VGEF, TNF…) producing these complications called “toxic tumor syndrome”. The goal of the surgery in this case is to remove the necrotic scar and to prevent long term somplications leading to secondary enucleation. The risk of “tumor toxic syndrome” is correlated to initial tumor volume. This surgical technique could be proposed in tumors of more than 8 mm thick but with a diameter of less than 16 mm, without ciliary body or optic nerve invasion. The surgical technique and the results will be described in this paper.