Autologous Corneal Transplant from an Enucleated Fellow Eye for Choroidal Melanoma: A Case Report

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Abstract

Background

To report a case of autologous corneal transplant in a patient with corneal leukoma and choroidal melanoma in the fellow eye.

Case Presentation

A 56-year-old woman was complaining about decrease in vision in her left eye. The patient was on the waiting list for a corneal transplant on her right eye due to corneal leucoma after a previous herpes infection. The patient was diagnosed with choroidal melanoma in her left eye. Due to the tumor size (longitudinal diameter >10 mm; anterior-posterior diameter >16 mm) the patient decided to undergo enucleation, after being informed about different treatment options (brachytherapy and enucleation). The patient showed her willingness to use the cornea of the left eye as a transplant for her right eye. After discussion with the ethical committee and its approval, and signing informed consent, the patient underwent enucleation of her left eye. The sample was examined by a pathologist and found to be free of melanoma cells in the corneolimbal tissue. Afterwards, trepanation of the donor cornea button was performed and transplanted to the left eye.

Conclusion

Autologous corneal transplantation is a safe and feasible procedure in selected cases.

Related collections

Most cited references 6

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To evaluate clinical features and life prognosis of uveal melanoma based on age at presentation. Retrospective, nonrandomized, interventional case series. Of 8,033 eyes with uveal melanoma, 106 (1%) were in young patients (≤20 years), 4,287 (53%) in mid adults (21-60 years), and 3,640 (45%) in older adults (>60 years). Based on age (young, mid adults, and older adults) at presentation, tumor epicenter was located in iris (21, 4, 2%; P < 0.0001), ciliary body (8, 5, and 7%; P = 0.0225), or choroid (71, 91, and 90%; P < 0.0001). Mean tumor diameter (10.2, 10.8, 11.5 mm; P < 0.0001), mean tumor thickness (5.0, 5.3, 5.7 mm; P < 0.0001), and extraocular extension (1, 2, and 4%; P = 0.0004) increased with age. Kaplan-Meier estimates of tumor-related metastasis at 3, 5, 10, and 20 years were 2%, 9%, 9%, and 20% in young patients (P < 0.011); 6%, 12%, 23%, and 34% in mid adults (P < 0.0001); and 11%, 19%, 28%, and 39% in older adults. Kaplan-Meier estimate of tumor-related death at 3, 5, 10, and 20 years were 0%, 2%, 5%, and 17% in young patients (P = 0.08); 3%, 6%, 11%, and 17% in mid adults (P < 0.001); and 7%, 11%, 16%, and 20% in older adults. Compared with mid adults and older adults, young patients manifested a higher proportion of iris melanoma. Compared with older adults, young and mid adults showed smaller melanoma basal dimension and lower tumor-related metastasis and death.

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The Third National Cancer Survey, 1969-71, reported 432 patients with noncutaneous melanoma, 79% originating in the eye. As with skin melanoma, ocular tumors were more common in whites than blacks and predominated in females at younger ages and males after middle life. On the other hand, ocular melanoma did not show the strong North-South gradient seen with skin melanoma; this suggested no relation to sunlight exposure.

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Author and article information

Journal

Journal ID (nlm-ta): Case Rep Ophthalmol

Journal ID (iso-abbrev): Case Rep Ophthalmol

Journal ID (publisher-id): COP

Title: Case Reports in Ophthalmology

Publisher: S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )

ISSN (Electronic): 1663-2699

Publication date Collection: May-Aug 2020

Publication date (Electronic): 14 May 2020

Publication date PMC-release: 14 May 2020

Volume: 11

Issue: 2

Pages: 181-188

Affiliations

[1] ^aPrivate Retina Office, University of Buenos Aires, Buenos Aires, Argentina

[2] ^bOphthalmology Division, Tel Aviv Medical Center affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

[3] ^cDiagnostic Ophthalmology Center, Buenos Aires, Argentina

[4] ^dUniversity Hospital Leipzig Department of Ophthalmology, Leipzig, Germany

Author notes

*Matias Iglicki, MD, Private Retina Office, University of Buenos Aires, 525 Aguirre Street, Buenos Aires 1414 (Argentina), matiasiglicki@ 123456gmail.com

Article

Publisher ID: cop-0011-0181

DOI: 10.1159/000507776

PMC ID: 7265731

SO-VID: ad615468-0c17-4ae1-8585-e6da49410487

License:

This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

History

Date received : 17 March 2020

Date accepted : 7 April 2020

Date: 2020

Page count

Figures: 5, References: 6, Pages: 8

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