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Surgical management of melanocytic tumors of the anterior segment of the eye
First Author: R. Wakfie Corieh SPAIN
Co Author(s): J. San Román Llorens P. Ávila Paz B. García Sandoval A. Garde González J. Artaechevarria Artieda I. Jiménez-Alfaro Morote
Describe the incidence, clinical evolution and histopathology diagnosis (HD) results of melanocytic tumors of the anterior segment (MTAS) that have been operated at the department of anterior segment.
Department of Ophthalmology. Fundaci�n Jim�nez D�az University Hospital. Madrid, Spain.
Retrospective descriptive study of a total 211 patients with MTAS by review of medical records in the period 2015-2020. Visual acuity, biomicroscopy, fundus, pre and postsurgical iconography, anterior segment optical coherence tomography, criteria and surgical technique and results were evaluated. Age, gender, location, surgery performed, HD, adjuvant treatment, and recurrence were analyzed.
Of the total MTAS (n = 221), 36 (16.29%) have been operated. Mean age of presentation was 46�16 years, 21 patients were women and 15 men. In 33.33% was located on the limbus, 30.56% bulbar conjunctiva, 16.67% caruncle, 8.33% lunate fold and 11.11% on pterygium (PT). Surgical criteria were: morphological changes (33%), location and depth (45%), symptomatic (6%) and cosmetic (16%). 12 eyes were treated with simple excision (SE), 10 with SE and conjunctival autograft, 5 with SE and suture, 2 with SE and conjunctival flap, 6 with SE and closure with Tissucol and 1 with ES, cryotherapy and autograft.
Conjunctival melanocytic lesions are the most common tumors of the conjunctiva. In the HD of our serie, we had 10 compound nevi, 16 subepithelial nevi, 2 blue nevi, 2 primary acquired melanosis (PAM), 4 PT with subepithelial nevus, 1 PT with PAM and 1 compound nevi with dysplasia (CND). All eyes were treated with corticosteroids and topical antibiotics, and the CND was treated with IFN-?2b. No lesions recurred. A number of non-neoplastic conditions can simulate neoplasms. In the majority, clinical findings should make the diagnosis obvious. However in some instances the HD may be necessary to exclude a neoplasm.
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