Surgical Approach in Intraocular Tumors

Abstract

Surgery in intraocular tumors is done for excision/biopsy and the management of complications secondary to the treatment of these tumors. Excision/biopsy of intraocular tumors can be done via fine-needle aspiration biopsy (FNAB), transretinal biopsy (TRB), partial lamellar sclerouvectomy (PLSU), and endoresection. FNAB, TRB, and PLSU can be used in tumors that cannot be diagnosed by clinical examination and other ancillary testing methods. PLSU is employed in tumors involving the iridociliary region and choroid anterior to the equator. Excisional PLSU is performed for iridociliary and ciliary body tumors with less than 3 clock hours of iris and ciliary body involvement and choroidal tumors with a base diameter less than 15 mm. However, for biopsy, PLSU can be employed with any size tumor. Endoresection is a procedure whereby the intraocular tumor is excised using vitrectomy techniques. The rationale for performing endoresection is based on the fact that irradiated uveal melanomas may cause complications such as exudation, neovascular glaucoma, and intraocular pigment and tumor dissemination (toxic tumor syndrome), and removing the dead tumor tissue may contribute to better visual outcome. Endoresection is recommended 1-2 weeks after external radiotherapy. Pars plana vitrectomy is also used in the management of complications including vitreous hemorrhage, retinal detachment, and epiretinal membrane that can occur after treatment of posterior segment tumors using radiotherapy and transpupillary thermotherapy. It is important to make sure the intraocular tumor has been eradicated before embarking on such treatment.

Correlation of TED Laterality with Thyroid Status among Thyroid Eye Disease (TED) Patients in a Tertiary Hospital in Indonesia

“…These findings were not much different from previous studies which reported that the incidence of these clinical features varied with range between 17.92% -63.25% (Ackuaku-Dogbe, Akpalu and Abaidoo, 2017;Muralidhar, Das and Tiple, 2020). These two clinical features are nonspecific features of TED and are manifestations of a soft tissue inflammatory process which is often an early sign of TED (Şahlı and Gündüz, 2017).…”

A novel technique of endoillumination-Assisted Localization Combined with Partial Transscleral Sclerouvectomy Ciliary Body Leiomyoma and its outcomes

“…In this study, we provided a new option for locating intraocular masses without vitrectomy. This endoilluminationassisted localization technique without vitrectomy has been applied in endolaser photocoagulation via a two-port pars plana nonvitrectomy approach [ [3] ]and endoilluminator-assisted scleral buckling [ [1] ]for the treatment of stage 3 Coats' disease and has achieved good results. The technology has many advantages, rst of all, it solves the problem of inaccurate positioning in traditional positioning methods.…”

“…Endoresection surgery [ [3] ]refers to intraocular tumor excision using vitreoretinal surgery methods. This surgical method can disrupt the normal tissue structure of the eye, resulting in a variety of complications[ [4] ], such as silicone oil dependence, retinal detachment, ocular hypertension or hypotension, vitreous hemorrhage, epiretinal membrane, eyeball atrophy, macular hole, choroidal neovascularization, proliferative vitreoretinopathy, and endophthalmitis.…”

Factors affecting eye conservation and metastasis in posterior uveal melanomas

“…7,8 Surgical removal via exoresection is performed in iridociliary, ciliary body, and anterior choroidal tumors. [9][10][11] Endoresection is usually performed in irradiated postequatorial choroidal melanomas to prevent complications related to toxic tumor syndrome and recurrences. [11][12][13] Radiotherapy (RT), applied either as brachytherapy (plaque RT) or teletherapy [proton beam therapy, stereotactic radiosurgery (SRS)] is the most common treatment option for medium sized PUM.…”

“…[9][10][11] Endoresection is usually performed in irradiated postequatorial choroidal melanomas to prevent complications related to toxic tumor syndrome and recurrences. [11][12][13] Radiotherapy (RT), applied either as brachytherapy (plaque RT) or teletherapy [proton beam therapy, stereotactic radiosurgery (SRS)] is the most common treatment option for medium sized PUM. [14][15][16][17][18][19][20][21][22] Plaque RT approaches with Ruthenium-106 (Ru-106), Iodine-125 (I-125), and less commonly Palladium-103 radioisotopes are widely used worldwide with proven efficacy in local tumor control.…”