RADICAL EXCISION OF THE CONJUNCTIVA IN THE THERAPY OF MALIGNANT-MELANOMA OF THE CONJUNCTIVA

Background In tumor excision of large malignant melanomas of the conjunctiva or in the excision of widespread precancerous melanosis the development of symblepharon is a threatening complication after conjunctivectomy, especially if the conjunctival fornix is afflicted. Patients Three patients with suspected nodular melanoma and surrounding precancerous melanosis of the conjunctiva were treated by extended excision of the conjunctiva. Instead of a conjunctival graft, spontaneous epithelisation under the protection of an 'Illig' contact lens was achieved. After this, two patients with histologically proven malignant melanomas were treated by beta-ray radiation with 90-Strontium. Results Within four weeks after the excision a complete epithelisation of the wound occurred and the functional as well as the cosmetic results were very satisfying. During the follow-up between 12 and 22 months no recurrence of the melanomas and no formation of symblepharon was observed. Conclusions With regard to these results extended tumor excision without conjunctival graft seems to be a reasonable therapy for large nodular melanomas and widespread melanosis, while the application of an 'Illig' contact lens avoids the formation of symblepharon.