Resection of ciliary body tumours wins EURETINA Video Awards

The intricacies of vitreoretinal surgery in all its glorious complexity was showcased in the 2014 

EURETINA Video Awards, with the very high standard of entries this year praised by Francesco 

Bandello, president of EURETINA.

First prize went to Maria Isabel Relimpio Lopez, of Spain for her video entitled “Partial Lamellar 

Sclerouvectomy of two ciliary body tumours: Two surgical techniques.” Joint second prize awards 

went to Peykan Turkcuoglu from Turkey for “Suprachoroidal haemorrhage during pars plana 

vitrectomy in a previously vitrectomised eye” and Shokufeh Tavassoli from the UK for “Top ten 

intravitreal injection tips”. Third prize was given to Avnindra Gupta from India for “Mystery Unfolds”, 

which explored surgical techniques for dealing with macular folds.

Dr Lopez’s prize-winning entry gave an elegant example of partial lamellar sclerouvectomy to deal 

with the rare incidence of ciliary body tumours in two patients. This surgical procedure is designed to 

remove the tumour and leave intact the outer sclera and sensory retina. 

In the video, Dr Lopez noted that malignant melanoma is the most common primary tumour in adults, 

with management and surgical strategy depending on the size and extent of the tumour. 

In the first case highlighted in the video, the surgeon used trans-illumination to mark the borders of 

the tumour before performing a series of sclerotomies away from the tumour site. Since the tumour in 

this patient did not affect the sclera, a partial-thickness scleral hinge was made. Cataract surgery was 

then performed without IOL implantation to avoid complications during the resection. The patient 

was anaesthetised using hypotensive anaesthesia, in which diastolic pressure was kept between 2 

mmHg to 4 mmHg to minimise bleeding. The tumour was dissected using scissors, and diathermy was 

used to coagulate the tissue. 

Technically challenging

After the resection was complete, a complete vitrectomy was performed with additional prophylactic 

endolaser applied to the fundus periphery. Any remaining tumour cells were destroyed using 

brachytherapy at the end of the surgery. The intraocular lens was injected three months later and 

improved the patient’s visual acuity to 0.3. Although technically challenging, the video demonstrated 

that partial lamellar sclerouvectomy can be effective in removing some malignant ciliary body 

tumours and maintaining good visual outcomes in such rare cases.