SURGICAL-MANAGEMENT OF MELANOCYTOMA OF THE CILIARY BODY WITH EXTRASCLERAL EXTENSION

We treated four white women with extrascleral extension of suspected c iliary body melanomas with a modified block excision (three patients) or enucleation (one patient). Light and transmission electron microsco py established the diagnosis of ciliary body melanocytoma with extrasc leral extension in each patient. Two eyes were irradiated before block excision. Block excision involved simultaneous removal of full-thickn ess cornea and sclera, iris, and ciliary body with tectonic corneoscle ral grafting. The postoperative visual acuity of the three patients tr eated with a modified block excision was 20/25, 20/50, and 20/60, resp ectively. No patient experienced local tumor recurrence (30 to 60 mont hs of follow-up). The two irradiated eyes eventually developed radiati on-associated complications. After three years the other block excisio n patient had visual acuity of 20/25. Ciliary body melanocytoma should be included in the differential diagnosis of pigmented tumors of the anterior uvea with extrascleral extension. En bloc excision with simul taneous full-thickness corneoscleral resection is indicated in circums cribed ciliary body tumors, especially when extraocular extension is p resent.