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November 1987

Sympathetic Ophthalmia Complicating Helium Ion Irradiation of a Choroidal Melanoma

Author Affiliations

From the Ocular Oncology Unit, the Department of Ophthalmology (Dr Fries, Char, Crawford, and Waterhouse), and the Francis I. Proctor Foundation (Dr Char), the University of California, San Francisco.

Arch Ophthalmol. 1987;105(11):1561-1564. doi:10.1001/archopht.1987.01060110107042

• Sympathetic ophthalmia was diagnosed 49 months after helium ion irradiation of a left choroidal melanoma. The patient maintained good vision until 18 months after therapy, when she developed neovascular glaucoma. This complication required multiple therapeutic procedures, including topical anti-inflammatory and antiglaucomatous drops, 360° peripheral panretinal cryoblation, and a single 180° application of inferior cyclocryotherapy over a 2½-year period. Four weeks after the cyclocryotherapy, inflammation was noted in both eyes, and, one month later, enucleation of the left sympathogenic eye was performed. Serial histopathologic sections showed a full-thickness, fibrovascular, scleral scar and tantalum marker ring suture without uveal incarceration. Penetrating surgical trauma, a uveal melanoma, and multiple nonpenetrating treatments resulted in the development of sympathetic ophthalmia.