Title : Cataract surgery in patients with uveal melanoma
Abstract:
Purpose. To analyse results of cataract surgery (CS) in patients with uveal melanoma (UM) after eye-preserving treatment.
Materials and methods. CS was performed in 152 patients after UM treatment: 52 patients were male (34%) and 100 were female (66%). Median age was 66 years (from 14 to 85). Median tumor thickness before UM treatment was 4,3 mm (from 1,16 mm to 9,5 mm), median basal diameter - 10 mm (from 2,5 mm to 19,6 mm). According to the UM TNM (AJCC) classification there were 67 eyes (56 %) of T1; T2 — 62 (42%); T3 — 18 (12 %). Brachytherapy with RU-106 was performed in 117 cases, stereotactic “Gamma-knife” radiosurgery - in 6 cases, transpupillary thermotherapy – in 20. Visual acuity (VA) before UM treatment ranged from 0,001 to 1,2 (in average 0,49). CS was performed in 36 months (from 3 to 284) after treatment of UM. CS was performed either with curative, or diagnostic purpose. Mean VA at the moment of CS was 0,18 (from 0,001 to 0,95). Phacoemulsification with intraocular lens implantation was performed in 148 cases (97,4 %), intracapsular cataract extraction - in 2 cases (1,3 %), extracapsular cataract extraction - in 2 cases (1,3 %).
Results. Median VA after CS was significantly higher than before - 0,43 (from 0,002 to 1,0) (p<0,001). There was no any complication detected within mean follow-up of 32 months (from 3 to 235). There was no extraocular growth or tumor recurrence after surgery detected also. Two patients were revealed to have metastases in 74 months and 78 months follow-up period after cataract surgery. Survival rate at 3 and 5 years of follow-up was 100%.
Conclusion. Due to the necessity of UM ophthalmoscopic control CS after tumor treatment is required and can significantly improve VA. No effect on local tumor control and survival was detected. Further investigation is needed.
