[Use of the scleral applicator for I 125 in the treatment of choroidal melanoma (long-term results)].

UNLABELLED: 19 patients with choroidal melanomas were included in a prospective study with iodine-125 plaque treatment from 1984 to 1989. The mean tumor height was 5.8 mm, the base diameter 11.6 mm, the tumor volume-calculated for the spherically shaped melanomas-80 to 510 mm3. None of the tumors had invaded the pars plana, 10 melanomas were localized < 3 mm from the fovea or disc. 1 eye had diabetic background retinopathy. Mean radiation dose to the apex was 57 to 90 Gy with a mean of 75 Gy, sclera contact dose was 350 Gy, the plague was in place 71/2 days. Follow-up 2 1/4 to 7 years, mean 5 years: in 11 patients follow-up is longer than 5 1/2 years. Half-time reduction of tumor volume was 6.7 months, of tumor height 13 1/2 months. During the first 5 years no tumor regrowth, late tumor regrowth in 2 eyes at 65 and 69 months.

COMPLICATIONS: radiation retinopathy in 17 eyes after 1 1/2 years with development of vitreous hemorrhage in 3 eyes, rubeosis iridis stage I in 3 eyes after 37 months, a cataract in 17 eyes after 28 months and an anterior ischemic optic neuropathy in 7 eyes after 15 months. Life expectancy: 2 patients died from metastases after 28 and 71 months, 1 patient alive with metastases after 17 months. Preoperative visual acuity: primarily it recovered postoperatively or it even improved due to disappearance of the accompanying exudative detachment or vitreous hemorrhage. However, after a follow-up of more than 2 years a deterioration of visual acuity occurred in all of the patients due to late radiogenic complications.