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Iris melanomas constitute between 3% and 10% of all malignant melanomas of the uvea and, unlike posterior uveal melanoma, have a low rate of metastasis.1
The most common way of treating circumscribed iris melanoma is by partial, usually sector, iridectomy,2 with iris reconstruction where possible. When the anterior chamber angle or ciliary body is involved, iridotrabeculectomy or iridocyclectomy should be performed. Complications of iridectomy include hyphema, cataract, wound dehiscence, episcleral seeding of the tumour and vitreous loss.1 Non-resectable iris melanoma can be treated by brachytherapy using radioactive plaque3 or proton beam irradiation.4 Diffuse iris melanoma, which often involves the trabecular meshwork and causes secondary glaucoma, is usually treated by enucleation.5
We describe herein a novel technique of sector iridectomy in treating circumscribed iris melanoma. The operation is performed by pushing the tumour out of the eyeball and excising it extraocularly, without intraocular intervention, in order to prevent anterior segment complications.
Six patients with growing pigmented iris lesions suspicious for iris melanoma, three of them proven histologically by punch biopsy, underwent resection using this new technique at the Hadassah-Hebrew University Medical Center between 2002 and 2007. All patients signed an informed consent for the described surgery. All …