The management of uveal melanomas with extrascleral extension

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Abstract
The authors' recommended management of uveal melanomas with extrascleral extension has undergone considerable change in recent years. Orbital exenteration is not always employed and other methods are now used, depending upon the type of extrascleral extension and how and when the extrascleral extension was detected. At present there appears to be no contraindication to using episcleral plaque radiotherapy for patients with small areas of extrascleral extension. However, the prognosis remains relatively poor regardless of the treatment employed. In future years we hope to have enough data to compare carefully cases with extrascleral extension treated by enucleation and those treated with radiotherapy. In view of the poor prognosis following exenteration, we believe that selected use of these alternative methods is justified.