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. 2025 Jun 1;45(6):1230-1235.
doi: 10.1097/IAE.0000000000004273.

Optimizing Surgical Performance and Safety in Endoresection of Uveal Melanoma

Mario R Romano  1   2 , Mariantonia Ferrara  3 , Alessandro Feo  1 , Anna Merico  4 , Martina Angi  4
Affiliations

Optimizing Surgical Performance and Safety in Endoresection of Uveal Melanoma

Mario R Romano et al. Retina. .

Abstract

Purpose: To present a standardized surgical technique for endoresection of uveal melanoma minimizing the risk of serious adverse events, including fatal gas embolism.

Methods: Ten uveal melanoma patients underwent endoresection following proton beam radiotherapy for radiotherapy-related vascular complications. Vortex veins located in correspondence of the tumor base had been cauterized at the time of tantalum markers placement. Endoresection was performed following complete 25-G vitrectomy, endolaser, and endodiathermy. The tumor was removed using a subretinal or transretinal approach depending on retinal infiltration. If needed, perfluorodecalin was injected to stabilize the retina. Fluid-silicone oil or perfluorodecalin-silicone oil exchange was performed, avoiding air.

Results: Endoresection was successfully performed in all eyes with no intraoperative complications. Mean follow-up was 10.8 months ± 3.2 months. One patient was enucleated due to neovascular glaucoma. At the last follow-up, the remaining patients had the eye preserved and no signs of local recurrence or neovascular glaucoma.

Conclusion: Our standardized surgical technique for uveal melanoma endoresection appeared to be safe, minimizing the risk of serious intraoperative and postoperative adverse events.

Keywords: exudative retinal detachment; iatrogenic vascular gas embolism; perfluorocarbon liquid; radiation-related vascular complications; secondary endoresection of uveal melanoma; silicone oil; toxic tumor syndrome.

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References

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