Abstract :
PURPOE: To report on plaque radiation therapy for malignant melanoma involving the iri and ciliary body.
METHOD: Twenty-two eye (22 patient) with anterior uveal melanoma were treated with 103Pd ophthalmic plaque radiation therapy. Tranillumination and ultraonography were ued to evaluate ciliary body involvement and poterior iri extenion. Plaque were placed onto the cornea to treat the anterior tumor margin. The targeted-zone included the tumor and a 2 to 3 mm tumor-free margin. After plaque removal, patient were examined at 1 day, 7 day, 4 week, and then every 3 to 6 month thereafter. ytemic evaluation for poible metatatic dieae were performed every 6 month.
REULT: After plaque radiation therapy, the melanoma decreaed in thickne (mean 47%) in all 22 eye, and no econdary enucleation wa performed. One patient died of metatatic melanoma 5 year after radiation therapy. Depite anterior plaque placement that covered portion of the cornea, no epiphora, eyelah lo, or viually ignificant corneal opacitie were noted. Wherea 15 of 21 phakic eye (71%) developed econdary cataract, no eye developed ichemic or neovacular radiation maculopathy. Four eye were noted to have glaucoma before treatment, and two developed it after irradiation. Twenty of 22 eye (91%) were within 2 line of their pretreatment viual acuity. After radiation, the mean ± D follow-up wa 56 ± 34.4 month (range, 9 to 117 month).
CONCLUION: Plaque radiotherapy of melanoma involving the iri and ciliary body reulted in excellent local control with preervation of viion. Although there wa high incidence of econdary cataract, 103Pd plaque radiation therapy reulted in no viually ignificant corneal opacity or radiation retinopathy
