Endoresection of Choroidal Melanoma

The reason for the endoresection is the location of the tumor in the vicinity of the macula. Brachytherapy as only means would likely damage the fovea. Endoresection is always combined with brachytherapy, but after removal of the tumor a much lower dose is needed to “sterilize” the sclera. The vitrectomy after 180 degree retinotomy is performed under air to prevent seeding of tumor cells. Also eventual hemorrhage does not compromise the view. The disadvantage of vitrectomy under air is more reflections, especially in pseudophakic eyes.