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April 1992

Cataract Surgery After Radiotherapy for Uveal Melanoma

Author Affiliations

Philadelphia, Pa

Arch Ophthalmol. 1992;110(4):473-474. doi:10.1001/archopht.1992.01080160051028

Malignant melanoma of the posterior uvea (ciliary body and choroid) is the most common primary, malignant, intraocular tumor. A perplexing aspect of this neoplasm is its marked predisposition to eventually exhibit hepatic metastasis in spite of the fact that initial liver enzyme levels and results of hepatic imaging studies are almost always normal when the eye tumor is treated by an ophthalmic oncologist.1 Some authors have proposed that manipulation of the eye by enucleation, radiotherapy, or other diagnostic or therapeutic maneuvers may promote systemic dissemination of the tumor.2 Consequently, emphasis has been placed on using "no touch" or "minimal manipulation" techniques at the time of enucleation or other procedures.1,3 In recent years, however, the "no touch" technique has become almost obsolete, although a minimal manipulation technique is still advocated.1,4

In view of these developments, is it not paradoxical that an ophthalmologist would purposely open a tumorcontaining

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