背景:睫状体肿瘤极为罕见,治疗具有挑战性。本研究的目的是介绍我们治疗这种罕见实体的经验,尤其是累及超过5小时的大肿瘤,并评估中国4例睫状体肿瘤通过部分板层巩膜切除术局部切除的手术效果和并发症。
方法:2019年10月至2023年4月,4例睫状体肿瘤患者在上海总医院接受了部分板层巩膜切除术,中国。肿瘤特征,组织病理学发现,并发症,视敏度,和手术结果在平均20.8个月的随访中进行了回顾.
结果:本研究包括4名平均年龄为31.8岁的患者。组织病理学诊断为非色素睫状上皮腺瘤(ANPCE),神经鞘瘤,和多个睫状体色素上皮囊肿。平均最大肿瘤基底直径为6.00mm(范围:2.00-10.00),平均肿瘤厚度为3.50mm(范围:2.00-5.00)。术前并发症包括3只(75%)眼白内障,晶状体错位2(50%),和继发性青光眼在1(25%)。在1例中观察到暂时性眼压减退,未观察到其他术后并发症。平均随访20.8个月,最佳矫正视力增加3只眼,稳定1只眼。所有眼睛均无肿瘤复发。随访结束时所有患者均存活。
结论:通过PLSU进行局部肿瘤切除术可用于睫状体肿瘤的治疗,包括占据超过5个小时的plicata的大肿瘤。通过充分的术前评估和手术期间的仔细操作,手术相关的并发症是可以控制的。
BACKGROUND: Ciliary body tumor is extremely rare and treatment is challenging. The aim of this study is to present our experience in treating this rare entity, especially large tumors with more than 5 clock hours of involvement, and to evaluate the surgical outcomes and complications of local resection via partial lamellar sclerouvectomy in four cases of ciliary body tumors in China.
METHODS: Four patients with ciliary body tumors underwent partial lamellar sclerouvectomy between October 2019 and April 2023 in Shanghai General Hospital, China. Tumor features, histopathologic findings, complications, visual acuity, and surgical outcomes were reviewed at a mean follow-up of 20.8 months.
RESULTS: Four patients with a mean age of 31.8 years were included in this study. The histopathological diagnosis was adenoma of non-pigmented ciliary epithelium (ANPCE), schwannoma, and multiple ciliary body pigment epithelial cysts. The mean largest tumor base diameter was 6.00 mm (range: 2.00-10.00) and the mean tumor thickness was 3.50 mm (range: 2.00-5.00). Preoperative complications included cataract in 3 (75%) eyes, lens dislocation in 2 (50%), and secondary glaucoma in 1 (25%). Temporary ocular hypotonia was observed in one
case and no other postoperative complications were observed. At a mean follow-up of 20.8 months, the best corrected visual acuity increased in 3 eyes and was stable in 1 eye. Tumor recurrence was absent in all eyes. All patients were alive at the end of follow-up.
CONCLUSIONS: Local tumor resection via PLSU is useful in the treatment of ciliary body tumors, including large tumors occupying more than five clock hours of pars plicata. Surgery-related complications were manageable with adequate preoperative assessment and careful operation during surgery.