Laser treatment of the new formation of the Iris and iridociliary zone

Abstract

Purpose: To determine the effectiveness of organ-preserving treatment of tumors of the iris and iridociliary zone by using techniques and laser radiation of different wavelengths. Methods: Clinical follow-up was carried out on 89 patients (89 eyes) with the tumor of the iris and iridociliary zone. The age of patients was 48.5±14.5 years. The size of the tumor was determined by ultrasound scanning: area (1.5 mm2 - 24 mm2), height (0.4 mm to 2.8 mm). Laser coagulation was performed with the use of lasers of λ=0.48, λ=0.85, λ=0.53 and λ=0.57 µm. Transscleral cyclophotocoagulation was performed when the tumor grew into the structure of the anterior chamber angle and to the ciliary body. The course of treatment was 1-3 sessions. Repeated courses were performed after 3-6 months. Results: After the first course of laser coagulation, swelling of tumor tissues, obliteration of newly formed vessels, and pinpoint hemorrhages were noted. Subsequently, an atrophic scar was formed at the site of exposure in places with fibrous detachment of the iris stroma and depigmentation. After subsequent courses of treatment, a tendency to decrease in area and height was noted. Tumor resorption was achieved in 83/89 eyes (93%). Surgical iridectomy was performed in 3/89 eyes (3%) due to the threat of tumor growth into the ciliary body. In one case, enucleation was performed due to continued tumor growth into the anterior chamber angle and the development of uncompensated secondary glaucoma. In cases where the tumor covered the pupil lumen before treatment, visual function improved after the course. No tumor recurrence was observed. Conclusion: The effectiveness of organ-preserving treatment of neoplasms of the iris and iridociliary zone was achieved in 93% of patients using lasers λ=0.48, λ=0.85, λ=0.53 and λ=0.57 μm, no matter what wavelengths were used. The choice of parameters of the laser technique depends on localization, the stage of pigmentation and the type of complications.