Resection of Intraocular Tumors (Partial Lamellar Sclerouvectomy) in the Pediatric Age Group

Purpose To describe the outcome of intraocular tumor resection by partial lamellar sclerouvectomy (PLSU) in the pediatric age group. Design Retrospective, interventional case series. Participants We included 37 patients who underwent PLSU for intraocular tumors under age 21 years. Methods Medical records were reviewed for clinical, operative, and histopathologic features. Main Outcome Measures Globe salvage, visual acuity, surgical side effects, tumor control, and tumor-related metastasis and death. Results The mean patient age was 9 years (median, 10; range, 0.25–17) and there were 22 (59%) females and 15 (41%) males. The tumor involved mainly the iris (n = 27; 73%), ciliary body (n = 7; 19%), or choroid (n = 3; 8%). The mean tumor basal dimension was 7 mm (median, 6; range, 3–15) and thickness was 3.6 mm (median, 3; range, 0.2–9.6). The histopathologic diagnosis was melanoma (n = 19; 51%), cyst (n = 5; 14%), medulloepithelioma (n = 4; 10%), melanocytoma (n = 3; 8%), lacrimal gland choristoma (n = 2; 5%), gliosis (n = 1; 3%), nevus (n = 1; 3%), hemorrhage (n = 1; 3%), and leiomyoma (n = 1; 3%). Intraoperative adverse effects included vitreous loss in 19 (51%) and hyphema in 4 (11%). Postoperative side effects included early transient hyphema in 9 (24%) and late cataract in 12 (32%). Local tumor recurrence was detected in 5 cases (13%) at mean interval of 28 months, including melanoma (n = 3) and medulloepithelioma (n = 2). Enucleation was necessary in 9 (24%) cases for recurrence in 3 (8%), prophylactic in eyes with high-grade malignancy in 5 (13%), and for blind painful eye in 1 (3%). Of the 28 salvaged eyes, final visual acuity was ≥20/40 in 18 (64%), 20/50 to 20/100 in 5 (18%), and