Stopa Marcin, Kociecki Jarosław, Rospond-Kubiak Iwona, Rakowicz Piotr
Z Katedry i Kliniki Okulistyki Uniwersytetu Medycznego w Poznaniu.
Klin Oczna. 2011;113(10-12):367-72.
To report choroidal melanoma treatment by endoresection.
A retrospective review of a series of 2 patients with choroidal melanoma that did not meet the criteria for brachytherapy. Both patients were treated by tumor endoresection supported by brachytherapy. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months. Preoperative evaluation included tumor measurements in ultrasound. Systemic evaluation (liver function test, chest x ray, abdominal ultrasound), was carried out to monitor possible metastases in the observation period.
The two operated patients were followed-up for 6 months. Visual acuity deteriorated from 5/16 (0.51 logMAR) preoperatively to 5/25 (0.7 logMAR) postoperatively in patient 1, and improved from 3/50 (1.22 logMAR) do 5/25 (0.7 logMAR) in patient 2. This corresponded to deterioration by 0.19 logMAR and improvement by 0.52 logMAR respectively. Neither tumor recurrence nor metastases were detected in the follow-up period.
Endoresection is a treatment option, alternative to enucleation, that can conserve the eye It sometimes can be performed in eyes that are not eligible for trans-scleral resection. Further larger studies are needed to establish the efficacy of this still controversial surgery.
报告脉络膜黑色素瘤的眼内切除术治疗情况。
回顾性分析2例不符合近距离放疗标准的脉络膜黑色素瘤患者。2例患者均接受了在近距离放疗支持下的肿瘤眼内切除术。观察指标包括术后1、3、6个月时的术前和术后视力。术前评估包括超声测量肿瘤大小。进行全身评估(肝功能检查、胸部X线、腹部超声)以监测观察期内可能的转移情况。
2例手术患者均随访6个月。患者1的视力从术前的5/16(0.51 logMAR)降至术后的5/25(0.7 logMAR),患者2的视力从3/50(1.22 logMAR)提高到5/25(0.7 logMAR)。这分别相当于视力下降0.19 logMAR和提高0.52 logMAR。随访期间未发现肿瘤复发或转移。
眼内切除术是一种可替代眼球摘除术的治疗选择,能够保留眼球。有时可在不符合经巩膜切除术条件的眼中进行。需要进一步开展更大规模的研究来确定这种仍存在争议的手术的疗效。