Objective To observe the therapeutic effects and security of the local resection for uveal melanoma, and to detect the factors which affect the prognosis. Methods The clinical data of 45 patients with uveal melanoma who had undergone local resection after examined by histopathology were retrospectively analyzed, including the age，sex，the longest diameter, the location of the tumor，with or without retinal detachment, intraocular pressure (IOP) and visual acuities before and after the operation, and the visual acuity. The relationship between the therapeutic method and the survival prognosis was analyzed. COX regression model was set up with knubbly metastasis relapse prognosis and the multiple factors which was the assistive variables. Results Among these factors, the metastasis and relapse had obvious relation to the longest diameter and height of the tumor(P=0.04), the IOP after operation(P=0.03), pathologic classification (P=0.04)、with or without scleral infiltration (P=0.03)、the location of the tumor (P=0.01) and complete or incomplete resection (P=0.00). The period when the metastasis and relapse of tumor were most likely to happen was 20 to 40 months. Conclusion Local resection is one of the effective methods for uveal melanoma. These patients should be followed up closely from 20 to 40 months after operation, and if necessary, should be treated combined with other treatments. (Chin J Ocul Fundus Dis, 2006, 22: 154-156)
Objective To evaluate the therapeutic effects of treatments of eye-retaining and enucleation for choroidal melanomas. Methods The clinical data of 44 patients (44 eyes) with choroidal melanomas after eye-retaining treatments and enucleation surgery were retrospectively analyzed. The metastasis, retention rate of eyeball after eye-retaining treatment, and visual acuity prognosis were observed and analyzed. In 44 eyes treated by eye-retaining therapy, transpupillary thermotherapy (TTT) was performed primaryly on 7 (15.9%), 106 Ru brachytherapy on 25 (56.8%), and local resection of tumor combined with 106 Ru brachytherapy on 12 (27.3%).The average follow-up period was 13.3 months. Results Forty-four patients had no melanoma metastasis during the follow-up period. In 39 patients (88.6%) who had their eyes retained successfully, the retention rate of eyeball was 100%, 92.9%, and 83.3% in 6, 14, and 24 eyes with small, middle, and large tumor, respectively. In the patients treated by eye-retaining therapy, the visual acuity was ge;0.3 in 11 (28.2%), ge;0.05-＜0.3 in 18 (46.2%), and ＜0.05 (25.6%) in 10 eyes. Conclusions 106 Ru brachytherapy and transpupillary thermotherapy are effective treatments for small and medium-sized choroidal melanomas; some selected cases with large choroidal melanomas was treated with local resection of tumor combined with106 Rubrachytherapy. However, longer followup will be necessary to assess if this treatment has a better comprehensive outcome, compared with enucleation surgery. (Chin J Ocul Fundus Dis, 2006, 22: 150-153)