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This abstract is assigned to session SBO-BOG Free papers: Tumoren/Tumeurs

Title

Proton beam radiotherapy for diffuse iris and ring melanoma: an alternative to enucleation

Purpose	Diffuse iris or ciliary body (‘ring’) melanoma is still considered an indication for enucleation. The current study examined proton beam irradiation of the whole anterior segment as an alternative, conservative treatment for these eyes with often good vision.
Methods	Consecutive case series of 38 patients (38 eyes) diagnosed with primary diffuse iris and/or ring melanoma and treated since 1992 with proton beam irradiation of the whole anterior segment. We studied patient survival, local tumor control, eye retention probability, final visual acuity, radiation induced side effects and their management.
Results	Median follow-up time was 22 months (range: 0-117). Patient survival was 100 % though three patients developed liver metastases recently. Local tumor control was 100 %. Eye retention probability was 97%. Median visual acuity was 0,7 (range: 0-1,2). Tumor and radiation induced side effects were cataract (71%), intraocular hypertension (71%) and ocular surface toxicity (16%). Their management consisted of phacoemulsification (47%), trabeculectomy (21%) or deep sclerectomy (39%), and preventive limbus deposition and reposition (LDR) (84%).
Conclusion	Proton beam irradiation of the whole anterior segment is a safe alternative to enucleation in diffuse iris or ring melanoma. Management of actinic cataract, glaucoma and ocular surface toxicity through modern techniques is essential for maintaining the eye and useful vision.

Author 1

Last name	SCHALENBOURG
Initials	A
Department	Jules Gonin Eye Hospital
City	Lausanne (VD), CH

Author 2

Last name	MAJO
Initials	F
Department	Jules Gonin Eye Hospital
City	Lausanne (VD), CH

Author 3

Last name	GOITEIN
Initials	G
Department	Paul Scherrer Institut
City	Villigen (AG), CH

Author 4

Last name	ZOGRAFOS
Initials	L
Department	Jules Gonin Eye Hospital
City	Lausanne (VD), CH