Surgery for eye cancer
UC Davis Comprehensive Cancer Center offers comprehensive, multidisciplinary care for patients with all stages of eye cancer aimed at preservation of eye sight, prevention of disease recurrence and spread and optimization of quality of life. Your team of cancer specialists will include experts in ophthalmology (including specialists in retinal surgery, pediatric eye surgery, orbital and eye plastics/reconstructive surgery and eye pathology), hematology and oncology, radiation oncology, diagnostic radiology, genetic counseling and pathology.
Eye cancers are not that common, but with prompt diagnosis and treatment, survival rates tend to be very high.
The two most common primary eye cancers are:
Intraocular melanoma: A disease in which malignant (cancer) cells form in the pigmented tissues of the eye — that is, the uvea, which includes the iris (your eye color), ciliary body or choroid. Intraocular melanoma can spread out of the eye by invading the eye wall (extrascleral extension) or spread to other organs (metastasis), the most common being the liver, lung, bone or areas under the skin. The tumor can be treated with radiation or removal of the eye when the cancer is confined to the eye. Five-year survival rates are excellent with treatment. It is the most common eye cancer in adults, but a rare cancer — just five people per million per year.
Retinoblastoma: Although retinoblastoma is rare, it accounts for 3 percent of all childhood cancers. It is the most common primary eye cancer in children with an incidence of one in 18,000 live births. It can affect one or both eyes and is usually diagnosed before age 6. When treated early, survival rates are excellent. Patients with hereditary retinoblastoma — estimated to be about 40 percent of all cases — are at risk for secondary malignancies despite successful treatment of the eye cancer, and will need regular monitoring by an oncologist.
Specific surgical procedures may include:
- Enucleation: This surgery removes the eye and part of the optic nerve. The eye will be checked with a microscope to see if there are any signs that the cancer is likely to spread to other parts of the body. This is done if the tumor is large and there is little or no chance that vision can be saved. An implant is placed to fill the eye socket at the time of surgery. After surgery, a prosthetic shell is used so that the operated eye looks as similar as possible to the normal eye. Close follow-up is needed for two years or more to check for signs of recurrence in the area around the eye. Enucleation may be used to treat either retinoblastoma or intraocular melanoma.
- Local tumor resection: This surgery removes the tumor and a small amount of healthy tissue around it. This treatment is used mostly for small intraocular melanomas confined to the front portion of the eye (i.e., iris).
- Exenteration: This surgery removes the eye and eyelid, and muscles, nerves and fat in the eye socket. The patient may be fitted for an artificial eye or facial prosthesis after exenteration. This treatment may be used for intraocular cancers with extension of the tumor through the eye wall to the surrounding tissue in the eye socket.
- Light laser: Laser is used to treat small retinoblastoma lesions or other benign small retinal tumors. It can be done in the clinic or operating room by the ophthalmologist.
- Cryopexy: This is a freezing procedure used to treat small peripheral retinoblastoma or other small benign retinal tumors. It can be done in the clinic or operating room and may require local or systemic anesthesia.
Grunwald JE, Daniel E, Ying G-S, Pistelli M, Maguire MG, Alesander J, Whittock-Martin R, Parker CR, Sepielli K, Blodi BA, Martin DF, the CATT Research Group (Park SS — Principal Investigator for UC Davis). Photographic assessment of baseline fundus morphology in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT). Ophthalmology. 2012 Aug;119(8):1634-41.
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Nguyen QD, Brown DM, Marcus DM, Boyet DS, Patel S, Feiner L, Gibson A, Sy J, Rundle AC, Hopkins JJ, Rubio RG, Ehrlich JS: RISE and RIDE Research Group (Park SS — Principal Investigator for UC Davis). Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012 April; 119: 789-801.
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Kim DY, Fingler J, Zawadzki RJ, Park SS, Morse LS, Schwartz D, Fraser S, Werner JS. Noninvasive imaging of the foveal avascular zone with high-speed phase-variance optical coherence tomography. Investigative Ophthalmology and Visual Science. 2012 January; 53: 85-92.
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Chin EK, Sedeek RW, Li J, Beckett L, Redenbo E, Chandra K, Park SS. Reproducibility of macular thickness measurement among five OCT instruments: effects of image resolution, image registration, and eye tracking. Ophthalmic Surgery, Lasers and Imaging. Mar-Apr;43(2):97-108.
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Watson GM, Keltner JL, Chin EK, Harvey D, Nguyen A, Park SS. Comparison of retinal nerve fiber layer and central macular thickness measurements among five different optical coherence tomography instruments in patients with multiple sclerosis and optic neuritis. Journal of Neuro-ophthalmology. 2011 June; 31: 110-116.
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Pilli S, Lim P, Zawadzki RJ, Choi SS, Werner JS, Park SS. Fourier-domain optical coherence tomography of eyes with epiretinal membrane: correlation between morphologic changes and visual function. Eye (London, England). 2011 June; 25: 775-783.
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Park SS, Truong SN, Zawadzki RJ, Alam S, Choi SS, Telander DG, Werner JS, Morse LS. High-resolution Fourier-domain optical coherence tomography of choroidal neovascular membranes. Investigative Ophthalmology and Visual Science. 2010 August; 51: 4200-4206.
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Park SS, Zawadzki RJ, Choi SS, Werner JS. Maculopathy diagnosed with high-resolution fourier-domain optical coherence tomography in eyes with previously unexplained visual loss. Retinal Cases & Brief Report. 2010; 4: 233-239.
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Sanket S, Morse LS, Park SS. Maculopathy associated with Prior Tamoxifen Use Diagnosed using Commercially Available Fourier-domain Optical Coherence Tomography. Journal of Clinic Experiment Ophthalmology. 2010; 1: 104. doi: 10.4172/2155-9570.1000104.
Lin LK, Lee H, Chang E. Pigmented basal cell carcinoma of the eyelid in Hispanics. Clinical Opthalmology. 2008 Sep; 2(3):641-3.
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Nandini Gandhi, M.D.
Assistant Professor of Ophthalmology & Vision Science
Pediatric Ophthalmology
Jennifer Li, M.D.
Assistant Professor of Ophthalmology & Vision Science
Corneal Disease and Surgery
Lily Koo Lin, M.D.
Associate Professor
Director of Ophthalmic Plastic and Orbital Surgery Service
Mark J. Mannis, M.D.
Professor and Chair of Ophthalmology & Vision Science
Corneal Disease and Surgery
Susanna S. Park, M.D., Ph.D.
Professor of Ophthalmology & Vision Science
Vitreo-Retinal Disease and Surgery
Ivan R. Schwab, M.D., F.A.C.S
Professor of Clinical Ophthalmology & Vision Science
Corneal Disease and Surgery
Director of Cornea & External Disease Service
Glenn Yiu, M.D., Ph.D.
Assistant Professor, Vitreoretinal Specialist
Dietitians
Danielle Baham, M.S., R.D.
Genetic Counselors
Nicole Mans, M.S., L.C.G.C.
Jeanna Welborn, M.D.Social Work
Sarah Conning, L.C.S.W., O.S.W.-C.