[Cryoenucleation in malignant melanoma of the choroid]

The works of Zimmermann, Fraunfelder et al. and Migdal offer reasons for postulating atraumatic procedures for the enucleation of malignant melanoma of the choroid. Cryosurgery represents an effective method of blocking the melanoma prior to enucleation in such a manner that an intraoperative dissemination of tumor cells is unlikely. The technology which is at present widely used for this purpose (Fraunfelder et al.) has considerable disadvantages. For examples cryoapplication is only possible with favorable, i.e., peripheral tumor localization, since the cryoapplicator cannot be introduced into the orbit. Therefore, a cup-shaped cryoapplicator chilled by liquid nitrogen has been developed which can be introduced into the orbit. The operating temperature of -196 degrees C causes the half of the eyeball in which the tumor is located to freeze within 100 seconds. Subsequently the applicator is removed and the enucleation is continued in the traditional manner. The technical suitability of this procedure has meanwhile been demonstrated in 12 enucleations.