Tumor volume reduction using combined phacoemulsification and intravitreal triamcinolone injection for the management of cataract with treated uveal melanoma and atypical nevi

Colleen M. Cebulla, Armando M. Alegret, William J Feuer, Wei Shi, Amy C. Schefler, Timothy G. Murray

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To study the reduction in tumor size and the safety and efficacy of combined phacoemulsification and intravitreal triamcinolone acetonide injection (phaco-IVTA) in patients with treated melanoma and atypical nevi. Setting: Bascom Palmer Eye Institute, Miami, Florida, USA. Methods: The medical records of 49 consecutive patients (51 eyes) with treated melanoma or atypical nevi treated with phaco-IVTA were evaluated retrospectively for changes in Snellen visual acuity, tumor volume, and frequency of complications. Main outcome measures included a postsurgical change in tumor size greater than or equal to 0.5 mm of height or 1.0 mm of basal diameter by echographic analysis, improvement in visual acuity at 6 months and final follow-up, and complications including endophthalmitis, cystoid macular edema, epiretinal membrane, increased intraocular pressure, and persistent corneal edema. Results: The median baseline visual acuity was 20/80 in the affected eye. At the 6-month follow-up examination, 13 (68%) of 19 eyes had achieved better than 20/40 visual acuity. Treated uveal melanomas (n = 30) and atypical choroidal nevi (n = 21) were stable with combined therapy, and echographic measurements improved in 12 eyes. Intraocular pressure increased from baseline to 25 mm Hg or more postoperatively in 4 of 51 eyes (8%). No other significant complications occurred. Conclusions: Combined phacoemulsification and IVTA was reasonably safe in patients with treated melanoma and atypical nevi. Tumors remained stable or decreased slightly in size. Intravitreal triamcinolone acetonide injection at the time of cataract surgery in patients with treated melanoma or nevus may reduce rates of tumor progression in these patients.

Original languageEnglish (US)
Pages (from-to)1669-1673
Number of pages5
JournalJournal of Cataract and Refractive Surgery
Volume34
Issue number10
DOIs
StatePublished - Oct 2008

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Triamcinolone
Intravitreal Injections
Phacoemulsification
Nevus
Tumor Burden
Cataract
Nevi and Melanomas
Triamcinolone Acetonide
Visual Acuity
Intraocular Pressure
Injections
Neoplasms
Epiretinal Membrane
Corneal Edema
Endophthalmitis
Macular Edema
Medical Records
Uveal melanoma
Melanoma
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

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Tumor volume reduction using combined phacoemulsification and intravitreal triamcinolone injection for the management of cataract with treated uveal melanoma and atypical nevi. / Cebulla, Colleen M.; Alegret, Armando M.; Feuer, William J; Shi, Wei; Schefler, Amy C.; Murray, Timothy G.

In: Journal of Cataract and Refractive Surgery, Vol. 34, No. 10, 10.2008, p. 1669-1673.

Research output: Contribution to journalArticle

Cebulla, Colleen M. ; Alegret, Armando M. ; Feuer, William J ; Shi, Wei ; Schefler, Amy C. ; Murray, Timothy G. / Tumor volume reduction using combined phacoemulsification and intravitreal triamcinolone injection for the management of cataract with treated uveal melanoma and atypical nevi. In: Journal of Cataract and Refractive Surgery. 2008 ; Vol. 34, No. 10. pp. 1669-1673.
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abstract = "Purpose: To study the reduction in tumor size and the safety and efficacy of combined phacoemulsification and intravitreal triamcinolone acetonide injection (phaco-IVTA) in patients with treated melanoma and atypical nevi. Setting: Bascom Palmer Eye Institute, Miami, Florida, USA. Methods: The medical records of 49 consecutive patients (51 eyes) with treated melanoma or atypical nevi treated with phaco-IVTA were evaluated retrospectively for changes in Snellen visual acuity, tumor volume, and frequency of complications. Main outcome measures included a postsurgical change in tumor size greater than or equal to 0.5 mm of height or 1.0 mm of basal diameter by echographic analysis, improvement in visual acuity at 6 months and final follow-up, and complications including endophthalmitis, cystoid macular edema, epiretinal membrane, increased intraocular pressure, and persistent corneal edema. Results: The median baseline visual acuity was 20/80 in the affected eye. At the 6-month follow-up examination, 13 (68{\%}) of 19 eyes had achieved better than 20/40 visual acuity. Treated uveal melanomas (n = 30) and atypical choroidal nevi (n = 21) were stable with combined therapy, and echographic measurements improved in 12 eyes. Intraocular pressure increased from baseline to 25 mm Hg or more postoperatively in 4 of 51 eyes (8{\%}). No other significant complications occurred. Conclusions: Combined phacoemulsification and IVTA was reasonably safe in patients with treated melanoma and atypical nevi. Tumors remained stable or decreased slightly in size. Intravitreal triamcinolone acetonide injection at the time of cataract surgery in patients with treated melanoma or nevus may reduce rates of tumor progression in these patients.",
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T1 - Tumor volume reduction using combined phacoemulsification and intravitreal triamcinolone injection for the management of cataract with treated uveal melanoma and atypical nevi

AU - Cebulla, Colleen M.

AU - Alegret, Armando M.

AU - Feuer, William J

AU - Shi, Wei

AU - Schefler, Amy C.

AU - Murray, Timothy G.

PY - 2008/10

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N2 - Purpose: To study the reduction in tumor size and the safety and efficacy of combined phacoemulsification and intravitreal triamcinolone acetonide injection (phaco-IVTA) in patients with treated melanoma and atypical nevi. Setting: Bascom Palmer Eye Institute, Miami, Florida, USA. Methods: The medical records of 49 consecutive patients (51 eyes) with treated melanoma or atypical nevi treated with phaco-IVTA were evaluated retrospectively for changes in Snellen visual acuity, tumor volume, and frequency of complications. Main outcome measures included a postsurgical change in tumor size greater than or equal to 0.5 mm of height or 1.0 mm of basal diameter by echographic analysis, improvement in visual acuity at 6 months and final follow-up, and complications including endophthalmitis, cystoid macular edema, epiretinal membrane, increased intraocular pressure, and persistent corneal edema. Results: The median baseline visual acuity was 20/80 in the affected eye. At the 6-month follow-up examination, 13 (68%) of 19 eyes had achieved better than 20/40 visual acuity. Treated uveal melanomas (n = 30) and atypical choroidal nevi (n = 21) were stable with combined therapy, and echographic measurements improved in 12 eyes. Intraocular pressure increased from baseline to 25 mm Hg or more postoperatively in 4 of 51 eyes (8%). No other significant complications occurred. Conclusions: Combined phacoemulsification and IVTA was reasonably safe in patients with treated melanoma and atypical nevi. Tumors remained stable or decreased slightly in size. Intravitreal triamcinolone acetonide injection at the time of cataract surgery in patients with treated melanoma or nevus may reduce rates of tumor progression in these patients.

AB - Purpose: To study the reduction in tumor size and the safety and efficacy of combined phacoemulsification and intravitreal triamcinolone acetonide injection (phaco-IVTA) in patients with treated melanoma and atypical nevi. Setting: Bascom Palmer Eye Institute, Miami, Florida, USA. Methods: The medical records of 49 consecutive patients (51 eyes) with treated melanoma or atypical nevi treated with phaco-IVTA were evaluated retrospectively for changes in Snellen visual acuity, tumor volume, and frequency of complications. Main outcome measures included a postsurgical change in tumor size greater than or equal to 0.5 mm of height or 1.0 mm of basal diameter by echographic analysis, improvement in visual acuity at 6 months and final follow-up, and complications including endophthalmitis, cystoid macular edema, epiretinal membrane, increased intraocular pressure, and persistent corneal edema. Results: The median baseline visual acuity was 20/80 in the affected eye. At the 6-month follow-up examination, 13 (68%) of 19 eyes had achieved better than 20/40 visual acuity. Treated uveal melanomas (n = 30) and atypical choroidal nevi (n = 21) were stable with combined therapy, and echographic measurements improved in 12 eyes. Intraocular pressure increased from baseline to 25 mm Hg or more postoperatively in 4 of 51 eyes (8%). No other significant complications occurred. Conclusions: Combined phacoemulsification and IVTA was reasonably safe in patients with treated melanoma and atypical nevi. Tumors remained stable or decreased slightly in size. Intravitreal triamcinolone acetonide injection at the time of cataract surgery in patients with treated melanoma or nevus may reduce rates of tumor progression in these patients.

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