Transscleral local resection

Eye-sparing transscleral local resection plays a limited role in the management of uveal melanoma. It is used in patients with large choroidal and ciliary body tumors who are not candidates for radiation therapy but are highly motivated to retain their eye.[10-12] The procedure is technically demanding and is generally performed only in centers with specialized expertise in this surgery. There is a substantial risk of retinal detachment, intraocular bleeding, and complications associated with the anesthesia-induced hypotension used to decrease the risk of bleeding. Either adjuvant brachytherapy or neoadjuvant proton-beam therapy are administered. Experience is limited to retrospective, single-center, case series.[10-12][Level of evidence C3]