Groh M. J. M., Holbach L., Kühnel B., Naumann G. O. H.

Department of Ophthalmology, University Erlangen-Nuernberg, Erlangen

Background: The therapy of malignant diseases of the conjunctiva with local chemo-therapy is an extension of the therapeutical options in this field. We report on our experience in the therapy of malignant melanomas of the conjunctiva.
Methods and Patients: Between March 1998 and April 2001 13 patients with malignant melanoma of the conjunctiva (6 female; 7 male; mean age 57 ± 13 years) were treated with local chemo-therapy. Mean follow-up time was 19 months (range 1-35 months). Ten patients underwent prior surgery, non of the patient was treated by local chemo-therapy before. In four patients the lid margin was involved in the malignant process. Local chemotherapy (mitomycin C 0.02% eyedrops; 5-times a day) was applicated after excisional biopsy in two cycles for 14 days with a 14-day break. In 4 patients a third cycle was included.
Results: Severe ocular or systemic secondary effects were not seen in our patients. Within the therapy chemosis and swelling of the lids were observed in all patients, with a total recovery after finishing the treatment. 9 patients were without recurrence within the follow-up time. In four patients a recurrence of the disease was observed., in these patients the lid was involved in the process. Visual acuity was 0.7 ± 0.2 after therapy (before 0.7 ± 0.2).
Conclusion: Local chemo-therapy with mitomycin C is a usefull option in the treatment of malignant melanomas of the conjunctiva. From our point of view the combination with excisional biopsy is of great benefit. Prognosis of conjunctival malignant melanomas involving the lid margin is nevertheless poor.

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