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Trabeculectomy in patients with uveal melanoma after proton beam therapy

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Abstract

Background

Retrospective evaluation of intraocular pressure, use of topical and systemic anti-glaucoma medication, secondary complications, local tumor control and survival in patients treated with trabeculectomy for the regulation of the intraocular pressure (IOP) after proton beam therapy for uveal melanoma.

Methods

In this retrospective clinical case series we evaluated the follow-up of 15 patients receiving a trabeculectomy as surgical treatment if the IOP could not be lowered adequately by medications or laser surgery. All patients had received proton beam therapy for uveal melanoma at the Helmholtz-Zentrum Berlin between 1998 and 2010.

Results

The median IOP decreased significantly from 35 mmHg ± 8.8 before TE to 16 mmHg ± 8.2 (=52.3 %) six months after TE (Wilcoxon-Mann–Whitney-U Test, p<0.01). None of the patients needed any glaucoma medication six months after trabeculectomy. Two patients developed local recurrence during follow-up, which were independent of the trabeculectomy. One patient had to be enucleated due to intractable pain and suspected remaining tumor activity. One patient died due to metastasis.

Conclusions

Trabeculectomy is an option in intractable glaucoma in patients with uveal melanoma after proton beam therapy in single cases. Secondary interventions are common. Inoculation metastases are possible. Secure local tumor control must be a prerequisite for filtrating operations.

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Authors and Affiliations

  1. Augenklinik/Department of Ophthalmology, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin Hindenburgdamm 30, D-12203, Berlin, Germany

    Aline I. Riechardt, Dino Cordini, Matus Rehak, Annette Hager, Ira Seibel, Alexander Böker, Enken Gundlach, Jens Heufelder & Antonia M. Joussen

  2. BerlinProtonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany

    Dino Cordini & Jens Heufelder

Authors
  1. Aline I. Riechardt
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  2. Dino Cordini
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  3. Matus Rehak
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  4. Annette Hager
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  5. Ira Seibel
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  6. Alexander Böker
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  7. Enken Gundlach
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  8. Jens Heufelder
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  9. Antonia M. Joussen
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Corresponding author

Correspondence to Aline I. Riechardt.

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Conflict of Interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Dr. E. Gundlach receives a grant (Ernst-und Berta Grimmke Stiftung; 89736040).

Funding-No funding was received for this research.

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Riechardt, A.I., Cordini, D., Rehak, M. et al. Trabeculectomy in patients with uveal melanoma after proton beam therapy. Graefes Arch Clin Exp Ophthalmol 254, 1379–1385 (2016). https://doi.org/10.1007/s00417-016-3310-5

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  • DOI: https://doi.org/10.1007/s00417-016-3310-5

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