Intraocular lens placement in the posterior chamber of eyes with regressed retinoblastoma and irradiation-induced cataract seems to be a safe and effective method for the correction of aphakia.

    Finger PT. Microwave thermo-radiotherapy for uveal melanoma: results of a 10-year study. Ophthalmology. 1997;104: 1794-1803.

    Adjuvant microwave thermotherapy can be used with reduced doses of ophthalmic plaque radiation therapy to control the growth of uveal melanomas. The visual acuities of microwave plaque thermo-therapy-treated eyes were found to be superior to those treated with radiation alone.

    Harbour JW, Char DH, Kroll S, et al. Metastatic risk for distinct patterns of postirradiation local recurrence of posterior uveal melanoma. Ophthalmology. 1997;104:1785-1792.

    Postirradiation local recurrence of posterior uveal mel-anoma is a risk factor for systemic metastasis. Vertical/diffuse recurrences may be associated more strongly with metastatic disease than are horizontal/marginal recurrences.

    Wong FL, Boice JD Jr, Abramson DH, et al. Cancer Incidence after retinoblastoma. Radiation dose and sarcoma risk. JAMA. 1997;278: 1262-1267.

    Genetic predisposition has a substantial impact on risk of subsequent cancers in retinoblastoma patients, which is further increased by radiation treatment. Retinoblastoma patients should be examined for new cancers and followed into later life to determine whether their extraordinary cancer risk extends to common cancers of adulthood.

    Gallie BL, Budning A, DeBoer G, et al. Chemotherapy with focal therapy can cure intraocular retinoblastoma without radiother-apy. Arch Opthalmol. 1996;114: 1321-1328.

    This pilot study suggests that most retinoblastomas are curable by combining chemotherapy with cyclosporine therapy, laser therapy, and cryotherapy without requiring external-beam radiotherapy.

    The Collaborative Ocular Melanoma Study Group. Factors predictive of growth and treatment of small choroidal melanoma: COMS Report No. 5. Arch Ophthalmol. 1997;115:1537-1544.

    Of small choroidal melanomas initially managed by observation, 21% demonstrated growth by two years and 31% by five years. The clinical and photographic features of these tumors confirm previous findings and are useful in identifying patients with small tumors at highest risk of short-term growth.

    Fishburne BC, Wilson DJ, Rosenbaum JT, et al. Intravitreal methotrexate as an adjunctive treatment of intraocular lymphoma. Arch Ophthalmol. 1997;115:1152-1156.

    The role of ocular radiation therapy must be weighed against the potential drawbacks. Injecting chemotherapeutic agents into the vitreous is worthy of consideration. Four patients treated to date at the authors’ institution have shown promising results. Intravitreal chemotherapy may result in improved treatment of intraocular lymphoma with reduced morbidity.

    The Collaborative Ocular Melanoma Study Group. Mortality in patients with small choroidal melanoma: COMS Report No. 4. Arch Ophthalmol. 1997;115:886-893.

    Otherwise healthy patients with an average age of 60 years and without a previous diagnosis of malignant disease who have small choroidal lesions judged to be melanoma have a low risk of dying within five years.

    Rudoler SB, Corn BW, Shields CL, et al. External beam irradiation for choroid metastases: identification of factors predisposing to long-term sequelae. Int J Radiat Oncol Biol Phys. 1997;38:251-256.

    Despite a variety of external-beam radiotherapy treatment (EBRT) techniques and the proximity of choroidal metastases to radiosensitive structures, complications of palliative EBRT were infrequent. Complications that do occur are related to host factors and do not appear to be a function of irradiation parameters.

    Rudoler SB, Corn BW, Shields CL, et al. Functional vision is improved in the majority of patients treated with external-beam radiotherapy for choroid metastases: a multivariate analysis of 188 patients. J Clin Oncol. 1997;15: 1244-1251.

    External-beam radiotherapy restores and maintains useful vision in patients with choroid metastases, with a globe preservation rate of 98%. Patients who are less that 55 years of age with pretreatment visual acuity better than 20/60 and tumor diameter less than 15 mm are most likely to benefit from this intervention.

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