RADICAL EXCISION OF THE CONJUNCTIVA IN TH E THERAPY OF MALIGNANT-MELANOMA OF THE CONJUNCTIVA

Background In tumor excision of large malignant melanomas of the conju nctiva or in the excision of widespread precancerous melanosis the dev elopment of symblepharon is a threatening complication after conjuncti vectomy, especially if the conjunctival fornix is afflicted. Patients Three patients with suspected nodular melanoma and surrounding precanc erous melanosis of the conjunctiva were treated by extended excision o f the conjunctiva. Instead of a conjunctival graft, spontaneous epithe lisation under the protection of an 'Illig' contact lens was achieved. After this, two patients with histologically proven malignant melanom as were treated by beta-ray radiation with 90-Strontium. Results Withi n four weeks after the excision a complete epithelisation of the wound occurred and the functional as well as the cosmetic results were very satisfying. During the follow-up between 12 and 22 months no recurren ce of the melanomas and no formation of symblepharon was observed. Con clusions With regard to these results extended tumor excision without conjunctival graft seems to be a reasonable therapy for large nodular melanomas and widespread melanosis, while the application of an 'Illig ' contact lens avoids the formation of symblepharon.