Efficacy of radiowave surgery in the treatment of patients with iris and ciliary body melanoma

Authors

  • A.P. Maletskiy SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)
  • O.V. Khomiakova SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine"; Odesa (Ukraine)

DOI:

https://doi.org/10.31288/oftalmolzh202033136

Keywords:

uveal melanoma, radiowave surgery unit, treatment

Abstract

Purpose: To determine the efficacy of resecting iris and ciliary body melanoma with the use of a 3.8-4.0-Mhz radiowave surgery unit.

Material and Methods: This study was conducted at Department of Eye Cancer, the Filatov Institute, from 2005 through 2018. The study group involved 45 patients with iris and ciliary body melanoma; the mean age was 56.3 ± 2.2 years, with a slight female predominance (53.3%). Sixty-seven patients who had undergone iridociliary melanoma excision using a conventional technique with cutting tools were used as retrospective controls. The eye examination included visual acuity measurement, perimetry, biomicroscopy and ophthalmoscopy. Tumor, nodus и metastasis (TNM) staging was according to the American Joint Committee on Cancer (AJCC). No metastases were seen at the time of enrollment. The mean tumor prominence at baseline was 4.0 ± 0.3 mm, with a mean base diameter of 8.3 ± 0.4 mm, corresponding to a tumor volume of 34.3 ± 0.7 mm3. All the patients of each group were divided into two subgroups based on baseline visual acuity. The study group involved subgroup 1A (n=37 patients; 82.2%) with a visual acuity of 0.1 to 0.5 and subgroup 1B (n=8 patients; 17.8%) with a visual acuity of 0.6 to 0.8, and the retrospective control group involved subgroup 2A (n=55 patients; 82.1%) with a visual acuity of 0.1 to 0.5 and subgroup 2B (n=12 patients; 17.9%) with a visual acuity of 0.6 to 0.8 (p > 0.05). The analysis was performed by analysis of variance (ANOVA) using Statistica 13.0 (Dell Statsoft Inc., Austin, TX). 

Results: The radiosurgical approach to treatment of iridociliary tumors in our patients allowed significantly reducing the rates of intraoperative and postoperative complications (?2=4.16; df=1; p=0.04). In addition, the rates of intraoperative and postoperative complications for the treatment of iridociliary tumors with cutting instruments were 9.1% and 10.4%, respectively. The use of a radiowave surgery unit for uveal melanoma resection allowed preserving baseline visual acuity in all patients, with a tumor recurrence rate of not more than 2.2%.

Conclusion: Early (12-month) treatment outcomes (visual functions and postoperative clinical course) and late treatment outcomes (visual functions; optic media; IOP; and tumor recurrence) for iridociliary melanoma resection using a radiowave 3.8-4.0 MHz unit allow us to state that high-frequency radiowave surgery enables reducing the risk of intraoperative and postoperative complications and, consequently, preserving a good visual function.

References

1.Aronow ME, Topham AK, Singh AD. Uveal Melanoma: 5-Year Update on Incidence, Treatment, and Survival (SEER 1973-2013). Ocul Oncol Pathol. 2018 Apr;4(3):145-151.https://doi.org/10.1159/000480640

2.Papastefanou VP, Cohen VM. Uveal Melanoma. J Skin Cancer. 2011;2011:1-13.https://doi.org/10.1155/2011/573974

3.Shields CL, Kaliki S, Furuta M, et al. American Joint Committee on Cancer Classification of Uveal Melanoma (Anatomic Stage) Predicts Prognosis in 7,731 Patients: The 2013 Zimmerman Lecture. Ophthalmology. 2015 Jun;122(6):1180-6. C https://doi.org/10.1016/j.ophtha.2015.01.026

4.Kim JH, Shin SJ, Heo SJ, et al. Prognoses and Clinical Outcomes of Primary and Recurrent Uveal Melanoma. Cancer Res Treat. 2017 Dec 28. doi: 10.4143/crt.2017.534. https://doi.org/10.4143/crt.2017.534

5.Chua V, Aplin AE. Novel therapeutic strategies and targets in advanced uveal melanoma. Curr Opin Oncol. 2018 Mar;30(2):134-41.https://doi.org/10.1097/CCO.0000000000000425

6.Khomiakova OV, Vit VV, Maletskyi AP. [Comparing structural changes in the rabbit's uveal tract after the use of a radiowave surgery unit versus a cutting tool]. J Ophthalmol (Ukraine). 2019;4:43-48. Ukrainian.

7.Ministry of Health of Ukraine. [Order of Ministry of Health of Ukraine No. 117 "On Approval of Protocols for Provision of Medical Care to Patients with Eye Disease"]. Kyiv, Ukraine; 15 March 2007. https://zakononline.com.ua/documents/show/107241___107241

8.Rebrova OIu. [Statistical analysis of medical data. Application of STATISTICA software package]. Moscow: MediaSfera. 2002. Russian.

9.Smoliakova GP, Pikhovskaia IG, Luz'ianina IG, Sorokin EL. [Method for radiosurgical treatment of uveal melanoblastoma]. Patent of Russian Federation RU No. 2265423 A61F dated 10.09.2006. Patent owner: Far East State Medical University. Application filed on 20.02.2005. Information Bulletin No. 34 issued 10.12.2005.

10.Yang J, Manson DK, Marr BP, Carvajal RD. Treatment of uveal melanoma: where are we now? Ther Adv Med Oncol. 2018 Feb 21;10:1758834018757175.https://doi.org/10.1177/1758834018757175

11.Uveal Melanoma. Available at: https://eyewiki.aao.org/Uveal_Melanoma#targetText=Associated%20with%20th.

Published

2025-10-15

How to Cite

[1]
Maletskiy, A. and Khomiakova, O. 2025. Efficacy of radiowave surgery in the treatment of patients with iris and ciliary body melanoma. Journal of Ophthalmology (Ukraine). 3 (Oct. 2025), 31–36. DOI:https://doi.org/10.31288/oftalmolzh202033136.

Issue

Section

Clinical Ophthalmology

Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 8 9 10 11 12 13 14 > >> 

You may also start an advanced similarity search for this article.