Background: The treatment of large uveal melanomas is always a challenge to the ophthalmic oncologist due to the expected long-term complications. The purpose of this study was to compare 125Iodine plaque brachytherapy with transscleral resection of large uveal melanomas in terms of preserving visual function and avoiding secondary enucleation.
Patients and methods: A total of 135 patients with similar tumor features were selected from a group of 211 patients with uveal melanomas where the tumor height was greater than 7.5 mm. Of these patients 87 were treated by 125Iodine brachytherapy and 48 patients by transscleral tumor resection. The mean follow-up time was 26 months.
Results: After transscleral resection 58% of the patients and after 125Iodine-brachytherapy 15% of the patients retained a visual acuity of > or = 0.1 after a follow-up of 28 months. Following iodine-brachytherapy there was a sixfold higher rate of secondary glaucoma. No difference was found with respect to the eye retention and mortality rate.
Conclusion: Patients with large melanomas eligible for transscleral local resection have a better visual function than those treated by 125Iodine brachytherapy.