What is the role of surgery in the treatment of intraocular tumors and glaucoma?

Updated: Jun 25, 2020
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

Surgical options to control intraocular pressure must be tempered by the need for preventing extraocular tumor spread. For smaller tumors, observation is warranted until growth is documented. Iridectomy or iridocyclectomy also are options for removing smaller tumors. For anterior tumors, argon laser trabeculopexy to tumor-free areas is an option. More posterior tumors may require local resection, photocoagulation, or episcleral radiopaque therapy. Enucleation or exenteration also is an option.

For melanocytoma, laser or surgical excision of the lesion may decrease the pigment load and decrease the intraocular pressure.

Glaucoma usually is associated with advanced stages of retinoblastoma, and enucleation may need to be discussed. Other therapeutic options include radiotherapy, cryotherapy, and photocoagulation. Any surgical intervention must be tempered by the risk of extraocular spread. [8]

Blind eyes should not undergo incisional glaucoma surgery because of the risk of spreading the tumor to outside the globe.


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