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[虹膜黑色素瘤。对11例接受手术切除治疗患者的回顾性研究]

[Iris melanomas. A retrospective study of 11 patients treated by surgical excision].

作者信息

Cardine S, Labetoulle M, Kirsch O, Di Nolfo M, Offret H, Frau E

机构信息

CHU de Kremlin-Bicêtre, Service d'Ophtalmologie, Le Kremlin-Bicêtre.

出版信息

J Fr Ophtalmol. 2003 Jan;26(1):31-7.

Abstract

INTRODUCTION

Iris melanoma, even when a malignant tumor, has a slow progressive course. Surgical treatment is easy because of localization of the tumor but can be accompanied by a range of complications, from photophobia to cosmetic problems.

MATERIALS AND METHODS

We reviewed the records of 11 patients with iris melanoma treated by surgical excision with posterior limbus incision. Conventional iridectomy was performed in nine cases and iridocyclectomy in two cases.

RESULTS

There were seven females and four males ranging in age from 27 to 76 years. Histologically, 10 tumors were composed of B spindle cells and one was mixed. For all patients, followed up for 1-5 years, final visual acuity was more than 6/10. One patient complained of photophobia and cataract developed in one 76-year-old woman at the end of follow-up.

CONCLUSION

Because of the good prognosis of iris melanoma, conservative treatment can be given in most of cases (without local complications). Surgical resection confirms diagnosis after histopathological examination, with good final functional result thanks to scleral tunnel incision, which induces less astigmatism than corneal incisions. In the future, these findings will have to be confirmed by a corneal topography study before and after surgery.

摘要

引言

虹膜黑色素瘤,即使是恶性肿瘤,其病程进展也较为缓慢。由于肿瘤位置表浅,手术治疗相对容易,但可能会伴随一系列并发症,从畏光到美容问题。

材料与方法

我们回顾了11例行后缘切口手术切除的虹膜黑色素瘤患者的病历。9例行传统虹膜切除术,2例行虹膜睫状体切除术。

结果

患者共7名女性和4名男性,年龄在27至76岁之间。组织学上,10个肿瘤由B型梭形细胞组成,1个为混合型。所有患者随访1至5年,最终视力均超过6/10。1例患者抱怨畏光,1名76岁女性在随访结束时出现白内障。

结论

由于虹膜黑色素瘤预后良好,大多数情况下(无局部并发症)可采取保守治疗。手术切除经组织病理学检查确诊,巩膜隧道切口导致的散光比角膜切口小,最终功能效果良好。未来,这些发现必须通过手术前后的角膜地形图研究来证实。

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