Saakyan S.V., Myakoshina E.B., Gevorkyan A.V. Analysis of the early results of laser treatment of the early choroidal melanoma in pseudophakia. Head and neck. Russian Journal. 2020;8(4):18–24 (In Russian).
The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, photographs of patients.
Background. Uveal melanoma is a malignant tumor of the vascular membrane of the eye with the most frequent localization in the choroid. Diagnosis and treatment of the tumor at the initial stages of its development is of important medical and social importance due to the tendency to early metastasis and poor vital prognosis.
So far the effectiveness of laser treatment of patients with primary choroidal melanoma in the presence of pseudophakia was not evaluated.
Purpose. To evaluate the effectiveness of laser treatment of patients with primary choroidal melanoma in the presence of pseudophakia.
Material and methods. The treatment of 30 patients with small choroidal melanoma and pseudophakia at the age of 74,1±5.3 years was conducted. The level of prominence of tumors, according to ultrasound data, was 1.1±0.3 mm, the diameter of the base-8.1±0.6 mm. Depending on the size of the tumor, patients underwent destructive laser coagulation and transpupillary thermotherapy, and 1 session of laser treatment was performed.
The follow-up period is 5.1±0.6 months.
Results. After treatment, in 22 (73,3%) of the 28 cases we revealed a chorioretinal scar on the fundus, which was confirmed by ultrasound and ОСT. Insufficient effect was observed in 8 (26,6%) from 30 patients with tumor localization in the middle periphery as a light-gray residual tumor, which was also confirmed by instrumental research methods. Biomicroscopic examination of the intraocular lens showed the stability of its position and transparency. Conclusion. Laser photocoagulation and transpupillary thermotherapy are the methods of choice in patients with early choroidal melanoma and pseudophakia. Morphometric studies can reveal a chorioretinal scar or residual tumor of the choroid with greater accuracy. To increase the effectiveness of laser operations for the early choroid melanoma and optimize the impact parameters, it is necessary to consider the aberrations of the artificial lens, especially when the formation is localized on the middle periphery of the fundus.
Key words: transpupillary thermotherapy, destroying laser coagulation, early melanoma of the choroid, pseudophakia, spectral optical coherence tomography.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.