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August 1999

Surgical Management of Conjunctival Melanomas

Arch Ophthalmol. 1999;117(8):1098-1099. doi:

In reply

Drs Francis, Coroneo, and Thompson seem to be critical of the technique that we advocate for removal of conjunctival melanoma,1-3 stating that our methods are too conservative. In the past, patients with conjunctival melanoma were often treated with simple excision only. That method is associated with increased local recurrence.4 The method that we have successfully employed for years for limbal melanoma is alcohol corneal epitheliectomy, wide excision of the tumor by partial lamellar sclerokeratitic conjunctivectomy using a "no touch" technique, and supplemental double freeze–thaw cryotherapy to the adjacent normal conjunctival margins.1-3 This method usually ensures complete tumor removal but leaves the conjunctiva intact so that the patient is comfortable. We have found that this technique is successful in complete tumor removal when histopathologic sections of the specimens are examined and patient follow-up is obtained.4