MELANOCYTOMALYTIC GLAUCOMA IN EYES WITH NECROTIC IRIS MELANOCYTOMA

Objective: Iris melanocytoma, although histologically benign, may unde rgo spontaneous necrosis with the resultant pigment dispersion causing secondary open-angle glaucoma. The authors describe the clinical find ings in three patients with this syndrome and review the current liter ature. Design: The study design was a small case series. Participants: Three patients with secondary glaucoma caused by a necrotic iris mela nocytoma participated. Intervention: Clinical records and pathologic p reparations were reviewed. The diagnosis of iris melanocytoma was conf irmed by histopathologic examination in all three cases. Results: All patients had intrinsically pigmented localized iris tumors and pigment ation of the angle. Hyperchromic heterochromia iridum was noticeable i n all patients. In two instances, a central crater in the lesion signi fied tumor necrosis. Two patients were treated successfully by surgica l resection of the iris tumor and the glaucoma resolved. One patient w as treated with enucleation. In all patients, histopathologic analysis disclosed extensively necrotic tumor comprised of maximally pigmented nevus cells with bland nuclei and infiltration of the trabecular mesh work by melanophages. Conclusion: Secondary glaucoma may result from o bstruction of the trabecular meshwork with necrotic iris melanocytoma, Resection of the tumor may relieve the glaucoma.