| Popis: |
The authors observed for 5-18 years 157 patients with malignant choroidal melanoma, age 19-80. Among them there were 57.96% men and 42.04% women. The treatment consisted in irradiation of the tumours with Co60 plaques according to Stallard's methods, and additionally, in the majority of patients, in xenon-arc photocoagulation. Complications developed after treatment were diagnosed. The most common complication was cataract, which occurred in 118 eyes (75.2%), average 2.5 years after irradiation, most commonly in the eyes where the tumour was located between the optic disc and the equator. Second most common complication were various lesions of vessels in retina and hemorrhages, which occurred in 105 eyes (66.9), average one year after irradiation, most often in the eyes with tumours of medium size. Another type of complications, retinopathy or maculopathy, was found in 99 eyes (63%), average 14 months after the beginning of the treatment. These lesions occurred more often in younger patients. The fourth complication was consecutive glaucoma. It was diagnosed in 71 eyes (45.2%), most often 1 to 5 years after irradiation. In many cases glaucoma was combined with other complications, which resulted in enucleation of 62% of ill eyes. The fifth complication were hemorrhages to vitreous. They occurred in 35 eyes (22.29%), much more often in the cases where photocoagulation was performed. The authors found glaucoma to be the most dangerous complication of the conservative treatment of choroidal melanoma, often leading to the loss of the eye. Other complications have negative influence on visual acuity. One should expect that application of other methods of irradiation and lower doses will limit the number of complications. |
