Exoresection via partial lamellar sclerouvectomy approach for uveal tumors: A successful performance by a novice surgeon

Abstract

Rengin Aslıhan Kurt, Kaan GündüzDepartment of Ophthalmology, Ankara University Faculty of Medicine, Ankara, TurkeyPurpose: To evaluate the results and complications of exoresection via a partial lamellar sclerouvectomy (PLSU) procedure for uveal tumors performed by a novice surgeon without help from an experienced surgeon.Methods: Medical records of 22 patients who underwent exoresection for uveal tumors between February 1999 and January 2009 were evaluated retrospectively. Exoresection was considered for tumors with their epicenter in the iris or in the ciliary body.Results: Twenty-two patients with a mean age of 45.9 years (range: 19–72 years) were included in this study. The histopathologic diagnosis was uveal malignant melanoma in 16 patients, iridociliary nevus in 2 patients, iris nevus in 2 patients, and iridociliary melanocytoma in 2 patients. Postoperative complications included cataract in 11 patients (50%), scleral thinning in 4 patients (18%), vitreous hemorrhage in 2 patients (9%), hyphema in 2 patients (9%), secondary glaucoma in 2 patients (9%), iridodialysis in 1 patient (4.5%), bullous keratopathy in 1 patient (4.5%), and posterior synechiae in 1 patient (4.5%). At a mean follow-up of 40.1 months (range: 1–98 months), there were no recurrences or metastatic events.Conclusions: Exoresection seems to be an effective treatment option in selected cases of iridociliary and ciliary body tumors. Novice surgeons with limited training in PLSU should not discourage themselves from doing this type of surgery. Several postoperative complications inevitably occur and require frequent patient monitoring.Keywords: uveal melanoma, uveal nevus, iris, ciliary body, choroid, iris nevus, iris melanoma, ciliary nevus, ciliary melanoma, choroidal melanoma, ciliochoroidal melanoma, iridociliochoroidal melanoma, partial lamellar sclerouvectomy, exoresectionErratum for this paper has been published