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Scleral patch grafts in the management of uveal and ocular surface tumors.
Ophthalmology 2012; 119(12):2631-6O

Abstract

OBJECTIVE

To evaluate the outcome of scleral patch grafts in a series of patients undergoing management for uveal and ocular surface tumors.

DESIGN

Case series.

PARTICIPANTS

Ten patients underwent scleral patch grafting. Five patients had uveal melanoma with extrascleral extension, 2 patients had scleromalacia secondary to plaque radiotherapy for uveal melanoma, 2 patients had suspicious uveoscleral nevi, and 1 patient had invasive conjunctival squamous cell carcinoma with scleral necrosis.

METHODS

Retrospective, interventional, noncomparative chart review of patients undergoing treatment for ocular tumors followed by scleral grafts in a tertiary eye care center in the United States between September 2003 and January 2011. Sclera was reconstructed with allogenic scleral grafts. Clinical observations were performed after grafting.

MAIN OUTCOME MEASURES

Structural integrity, appearance, and stability of the grafts.

RESULTS

Ten patients were reviewed. All melanoma cases received plaque radiotherapy with palladium 103. The cases with nevi and squamous cell carcinoma underwent local resection with cryotherapy as primary treatment. In 8 cases, scleral grafting was performed as part of the initial surgery. In all of these cases, satisfactory anatomic and functional outcomes were achieved. In 2 cases with scleromalacia secondary to radiotherapy for uveal melanoma, grafts were placed several years after the initial treatment. In these 2 cases, one showed signs of graft retraction, whereas another showed graft thinning. No patients experienced graft infection, rejection, or tumor recurrence.

CONCLUSIONS

In this series, scleral grafts were well accepted when placed as part of the primary tumor management despite synchronous radiotherapy, scleral resection, or cryotherapy. Grafting was less successful when performed as a late procedure for radiation-induced scleromalacia.

FINANCIAL DISCLOSURE(S)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Authors+Show Affiliations

The New York Eye Cancer Center, New York, New York; The New York Eye and Ear Infirmary, New York, New York 10065, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22858126

Citation

Barman, Manabjyoti, et al. "Scleral Patch Grafts in the Management of Uveal and Ocular Surface Tumors." Ophthalmology, vol. 119, no. 12, 2012, pp. 2631-6.
Barman M, Finger PT, Milman T. Scleral patch grafts in the management of uveal and ocular surface tumors. Ophthalmology. 2012;119(12):2631-6.
Barman, M., Finger, P. T., & Milman, T. (2012). Scleral patch grafts in the management of uveal and ocular surface tumors. Ophthalmology, 119(12), pp. 2631-6. doi:10.1016/j.ophtha.2012.06.024.
Barman M, Finger PT, Milman T. Scleral Patch Grafts in the Management of Uveal and Ocular Surface Tumors. Ophthalmology. 2012;119(12):2631-6. PubMed PMID: 22858126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scleral patch grafts in the management of uveal and ocular surface tumors. AU - Barman,Manabjyoti, AU - Finger,Paul T, AU - Milman,Tatyana, Y1 - 2012/08/01/ PY - 2012/03/13/received PY - 2012/06/15/revised PY - 2012/06/15/accepted PY - 2012/8/4/entrez PY - 2012/8/4/pubmed PY - 2013/2/8/medline SP - 2631 EP - 6 JF - Ophthalmology JO - Ophthalmology VL - 119 IS - 12 N2 - OBJECTIVE: To evaluate the outcome of scleral patch grafts in a series of patients undergoing management for uveal and ocular surface tumors. DESIGN: Case series. PARTICIPANTS: Ten patients underwent scleral patch grafting. Five patients had uveal melanoma with extrascleral extension, 2 patients had scleromalacia secondary to plaque radiotherapy for uveal melanoma, 2 patients had suspicious uveoscleral nevi, and 1 patient had invasive conjunctival squamous cell carcinoma with scleral necrosis. METHODS: Retrospective, interventional, noncomparative chart review of patients undergoing treatment for ocular tumors followed by scleral grafts in a tertiary eye care center in the United States between September 2003 and January 2011. Sclera was reconstructed with allogenic scleral grafts. Clinical observations were performed after grafting. MAIN OUTCOME MEASURES: Structural integrity, appearance, and stability of the grafts. RESULTS: Ten patients were reviewed. All melanoma cases received plaque radiotherapy with palladium 103. The cases with nevi and squamous cell carcinoma underwent local resection with cryotherapy as primary treatment. In 8 cases, scleral grafting was performed as part of the initial surgery. In all of these cases, satisfactory anatomic and functional outcomes were achieved. In 2 cases with scleromalacia secondary to radiotherapy for uveal melanoma, grafts were placed several years after the initial treatment. In these 2 cases, one showed signs of graft retraction, whereas another showed graft thinning. No patients experienced graft infection, rejection, or tumor recurrence. CONCLUSIONS: In this series, scleral grafts were well accepted when placed as part of the primary tumor management despite synchronous radiotherapy, scleral resection, or cryotherapy. Grafting was less successful when performed as a late procedure for radiation-induced scleromalacia. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/22858126/Scleral_patch_grafts_in_the_management_of_uveal_and_ocular_surface_tumors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(12)00555-6 DB - PRIME DP - Unbound Medicine ER -