Malignant Melanoma of Ocular Surface

Neelam Pushker¹, Mridula Mehta¹, Seema Kashyap¹, Mandeep S. Bajaj¹, Supriyo Ghose¹, Kanchan Chawhan¹

¹Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India

Purpose: To report the clinical presentation and management of malignant melanoma of the ocular surface.

Methods: We studied 20 patients of ocular surface malignant melanoma who presented at a tertiary eye care centre. Their demographic profile and clinical details were analysed. The management and its outcome were also studied.

Results: Out of 20, eleven were females. The age ranged from 40 to 70 years. The duration of lesion ranged between 2 months and 8 years. Four had lesion predominantly on upper lid palpebral conjunctiva, 4 had lower lid palpebral conjunctiva, 2 had forniceal conjunctiva, 5 had bulbar conjunctiva, and 5 had diffuse involvement. All patients presented with slowly increasing mass lesion, 4 had associated pain and redness, and 3 had bleeding from the lesion. Previous surgery was done in 6 patients. Two patients had corneal and 7 had orbital involvement. Six patients had areas of PAM and 6 had history of nevus. Thirteen patients underwent mass excision with cryotherapy of the margins and application of 0.02% mitomycin C on the surface followed by lid reconstruction, 3 were treated with excision under frozen-section control followed by lid reconstruction and rest four were exenterated. In addition, 2 were given orbital radiotherapy. Seven patients have had recurrence and 2 patients had lymph node metastasis.

Conclusions: We preferred excision of the lesion under frozen-section control of margins with adjunctive treatment in most of the patients. In patients with extensive orbital involvement exenteration was done.