Oftalʹmologiâ (Jul 2014)
Intraocular electrochemical lysis during large choroidal melanoma endoresection
Abstract
Purpose: clinical case of intraocular electrochemical lysis technique at the stage of endoresection for large choroidal melanoma.Methods: Endoresection with intraoperational intraocular electrochemical lysis (ECL) was performed in one patients (1 eyes) with large choroidal melanoma T3N0M0 (tumor thickness — 10 mm, base diameter — 13,7 x 15,4 mm, juxtapapillary localization). The original method of two platinum electrodes (extrascleral anode and intraocular cathode) combined positioning was used for ECL during endoresection. Removed material was examined morphologically.Results: The tumor was removed completely. The anatomical retinal reattachment was reached. Morphological examinations testified ECL efficacy for both tumor and tumor cells destruction. Material removed during endoresection corresponded to tumor fragments in pathomorphism. There were different necrosis extensive fields: acellular detritus with tumor parenchyma complete destruction, tumor parenchyma lixiviation; coagulation necrosis with destroyed parenchyma and compacted tumor stroma. An absence of viable tumor cells and tumor fragmentation did not allow to verify histologic tumor structure.Conclusion: New vitreoretinal technologies and new intraocular methods that destroyed tumor tissue could make the endoresection perspective and reassuring organ-safe treatment mode.