Intrascleral recurrence of uveal melanoma after transretinal “endoresection”

Editor,—Conservation of the eye and vision in patients with juxtapapillary choroidal melanoma is still a challenge. Both plaque radiotherapy and proton beam radiotherapy tend to cause optic neuropathy, which is associated with disc and iris neovascularisation, vitreous haemorrhage, and neovascular glaucoma. These complications can also occur after phototherapy, which is less effective than radiotherapy at destroying the deeper parts of the tumour. Transscleral local resection of posterior tumours is especially difficult with tumours extending close to the optic disc and is associated with an increased incidence of local tumour recurrence. For these reasons, techniques have been developed for removing posterior choroidal melanomas transretinally, using standard vitrectomy equipment. In a previous report, eight out of 52 cases received secondary photocoagulation for possible tumour recurrence at the margins of the surgical coloboma and one enucleated eye was found to have microscopic tumour deposits within the coloboma.We report a case of intrascleral tumour recurrence.