[Transpupillary thermotherapy in the primary management of choroidal melanoma]

To determine if primary transpupillary thermotherapy can achieve local remission of choroidal melanoma. Secondary objectives were to determine safety of treatment, visual acuity and evaluate complications. The long term objective was to evaluate the impact of treatment on survival without metastatic disease.

Thirty-one patients with small choroidal melanomas were treated with transpupillary thermotherapy between 1st December 1997 and 15th June 2001. These patients satisfied predetermined inclusion criteria. To perform the treatment, an infrared diode laser (810 nm) with emission adapted for use with a surgical microscope was used, applying the treatment through a Mainster contact lens. In most patients, the diameter of the irradiation beam was 2 mm, the exposure time was 1 minute and the level of energy given was between 250 and 800 mW.

Of 31 patients treated, 26 patients were evaluated in this study. With a mean follow-up of 23.13 months (standard deviation (S.D.): 15 and median: 18.6 months), tumoral remission was observed in 50% of the evaluated tumors. The post-treatment visual acuity in the patients with tumoral remission was better than in patients with treatment failure (P = 0.004).

Primary treatment of choroidal melanomas with transpupillary thermotherapy may be a good therapeutic option in selected cases.