Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors
Purpose. To report the surgical treatment and follow-up of tumors of the anterior uvea and epithelial cysts of the anterior chamber in 4 patients submitted to block excision and tectonic corneal graft between 2008 and 2012. Methods. This is a retrospective, nonrandomized case series. Two patients we...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2019/4153064 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832553400756076544 |
|---|---|
| author | Emilio Balestrazzi Luigi Mosca Maria Antonietta Blasi Maria Ilaria Giannico Angelo Balestrazzi |
| author_facet | Emilio Balestrazzi Luigi Mosca Maria Antonietta Blasi Maria Ilaria Giannico Angelo Balestrazzi |
| author_sort | Emilio Balestrazzi |
| collection | DOAJ |
| description | Purpose. To report the surgical treatment and follow-up of tumors of the anterior uvea and epithelial cysts of the anterior chamber in 4 patients submitted to block excision and tectonic corneal graft between 2008 and 2012. Methods. This is a retrospective, nonrandomized case series. Two patients were affected by anterior uveal malignant melanoma, and 2 patients were referred to us for large epithelial iris cysts with anterior chamber angle involvement and partial corneal failure. A simultaneous block removal of the lesion and adjacent iris, cornea (when necessary), ciliary body, and sclera was performed; the resulting defect was covered by a tectonic whole thickness corneal graft. Follow-up ranged from 2 to 7 years (mean time: 5 ± 1.6 MD). Results. Local control of malignant melanoma was observed during the follow-up, but cataract surgery was planned in both patients and pars plana vitrectomy for vitreous hemorrhage occurred in one case. No recurrence of cysts was detected. After iris cysts excision, a planned second-time surgery was necessary in one patient: optical penetrating keratoplasty, centered on the visual axis, implantation of one refractive IOL (intraocular lens) in the bag, and one cosmetic IOL in the sulcus, to restore the iris diaphragm. Conclusions. Block excision followed by the tectonic corneal graft seems to be the treatment of choice for selected cases of epithelial cysts of the anterior chamber and anterior uvea melanomas with epibulbar extension. Further surgery, as a second step, could be required to improve functional results of this challenging technique. |
| format | Article |
| id | doaj-art-6733f1d418b3405c89fb6152a898c127 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-6733f1d418b3405c89fb6152a898c1272025-02-03T05:53:59ZengWileyJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/41530644153064Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular TumorsEmilio Balestrazzi0Luigi Mosca1Maria Antonietta Blasi2Maria Ilaria Giannico3Angelo Balestrazzi4Studio Oculistico Associato Balestrazzi, Rome, ItalyDepartment of Ophthalmology, Catholic University, Policlinico Gemelli Hospital, Rome, ItalyDepartment of Ophthalmology, Catholic University, Ocular Oncology Unit, Policlinico Gemelli Hospital, Rome, ItalyStudio Oculistico Associato Balestrazzi, Rome, ItalyDepartment of Ophthalmology, “Misericordia” Hospital, Grosseto, ItalyPurpose. To report the surgical treatment and follow-up of tumors of the anterior uvea and epithelial cysts of the anterior chamber in 4 patients submitted to block excision and tectonic corneal graft between 2008 and 2012. Methods. This is a retrospective, nonrandomized case series. Two patients were affected by anterior uveal malignant melanoma, and 2 patients were referred to us for large epithelial iris cysts with anterior chamber angle involvement and partial corneal failure. A simultaneous block removal of the lesion and adjacent iris, cornea (when necessary), ciliary body, and sclera was performed; the resulting defect was covered by a tectonic whole thickness corneal graft. Follow-up ranged from 2 to 7 years (mean time: 5 ± 1.6 MD). Results. Local control of malignant melanoma was observed during the follow-up, but cataract surgery was planned in both patients and pars plana vitrectomy for vitreous hemorrhage occurred in one case. No recurrence of cysts was detected. After iris cysts excision, a planned second-time surgery was necessary in one patient: optical penetrating keratoplasty, centered on the visual axis, implantation of one refractive IOL (intraocular lens) in the bag, and one cosmetic IOL in the sulcus, to restore the iris diaphragm. Conclusions. Block excision followed by the tectonic corneal graft seems to be the treatment of choice for selected cases of epithelial cysts of the anterior chamber and anterior uvea melanomas with epibulbar extension. Further surgery, as a second step, could be required to improve functional results of this challenging technique.http://dx.doi.org/10.1155/2019/4153064 |
| spellingShingle | Emilio Balestrazzi Luigi Mosca Maria Antonietta Blasi Maria Ilaria Giannico Angelo Balestrazzi Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors Journal of Ophthalmology |
| title | Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors |
| title_full | Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors |
| title_fullStr | Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors |
| title_full_unstemmed | Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors |
| title_short | Tectonic Keratoplasty to Restore the Bulbar Wall after Block Excision of Benign and Malignant Intraocular Tumors |
| title_sort | tectonic keratoplasty to restore the bulbar wall after block excision of benign and malignant intraocular tumors |
| url | http://dx.doi.org/10.1155/2019/4153064 |
| work_keys_str_mv | AT emiliobalestrazzi tectonickeratoplastytorestorethebulbarwallafterblockexcisionofbenignandmalignantintraoculartumors AT luigimosca tectonickeratoplastytorestorethebulbarwallafterblockexcisionofbenignandmalignantintraoculartumors AT mariaantoniettablasi tectonickeratoplastytorestorethebulbarwallafterblockexcisionofbenignandmalignantintraoculartumors AT mariailariagiannico tectonickeratoplastytorestorethebulbarwallafterblockexcisionofbenignandmalignantintraoculartumors AT angelobalestrazzi tectonickeratoplastytorestorethebulbarwallafterblockexcisionofbenignandmalignantintraoculartumors |