{"schema_version":"bookimed.page-context.v1","id":"method-oncosurgery-op1408","url":"https://hub.bookimed.com/oncologic-surgery/method-oncosurgery-op1408/","json_url":"https://hub.bookimed.com/oncologic-surgery/method-oncosurgery-op1408/#page-context","content_revision":"prepared-registry-v2","date_modified":"2026-10-21","language":"en","kind":"guide","title":"Ocular oncology surgery","summary":"Ocular oncology surgery covers different procedures for eye tumours rather than one operation. For squamous neoplasia of the eye surface—abnormal growth in its surface cells—surgical excision removes the affected tissue. Medicines applied to the eye surface offer another treatment approach. For choroidal melanoma, a cancer inside the eye, iodine-125 plaque brachytherapy delivers radiation from a plaque placed against the outside of the eye; this differs from enucleation, which removes the eye. Proton therapy is another form of radiation treatment for ocular tumours. Its planning combines eye imaging, assessment by an eye specialist and surgery to place clips.","research_credit":{"name":"Yevhenii Kozlov","role":"Co-Founder of Bookimed","url":"https://us-uk.bookimed.com/ceo/kozlov/","contribution":"Research project led","assistance":"For me, helping patients find the best medical care is a personal responsibility. This guide is built by a process we designed to do the hard part — reading the research, comparing surgeons and clinics, checking real offers — and to make the result simple and clear for every patient. AI tools do much of the work; every fact links to its source."},"editorial_scope":"Source-linked research and public provider information. Individual treatment requires clinical assessment.","research_method":"How this guide is researched and compared Research project led by Yevhenii Kozlov .","sections":[{"id":"narrative-mechanism_and_choices","title":"How surgery works and how approaches differ","text":"How surgery works and how approaches differ Ocular oncology surgery covers different procedures for eye tumours rather than one operation. For squamous neoplasia of the eye surface—abnormal growth in its surface cells—surgical excision removes the affected tissue. Medicines applied to the eye surface offer another treatment approach. For choroidal melanoma, a cancer inside the eye, iodine-125 plaque brachytherapy delivers radiation from a plaque placed against the outside of the eye; this differs from enucleation, which removes the eye. Proton therapy is another form of radiation treatment for ocular tumours. Its planning combines eye imaging, assessment by an eye specialist and surgery to place clips. Sources (3) Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis. The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19. PTCOG Ocular Statement: Expert Summary of Current Practices and Future Developments in Ocular Proton Therapy.","links":[{"label":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis.","url":"https://pubmed.ncbi.nlm.nih.gov/35987957/"},{"label":"The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19.","url":"https://pubmed.ncbi.nlm.nih.gov/32200815/"},{"label":"PTCOG Ocular Statement: Expert Summary of Current Practices and Future Developments in Ocular Proton Therapy.","url":"https://pubmed.ncbi.nlm.nih.gov/38971383/"}]},{"id":"narrative-indications_and_alternatives","title":"When surgery may help and what alternatives to discuss","text":"When surgery may help and what alternatives to discuss The alternatives depend on the particular eye condition. For ocular surface squamous neoplasia, treatments studied alongside excision include medicines applied to the eye: fluorouracil, interferon alfa-2b and mitomycin-C. These comparisons concern surface disease, not melanoma inside the eye. A separate diagnostic procedure, vitrectomy for biopsy, can help identify the cause of unexplained disease affecting the vitreous, retina or choroid—the gel inside the eye and tissues at the back of the eye. Its purpose is to help establish a diagnosis, rather than to establish that cancer has been removed. After radiation treatment for uveal melanoma, selected patients may need further surgery inside the eye to manage damage associated with remaining dead tumour tissue. This is a different situation from choosing the initial cancer treatment. Sources (3) Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis. [Chinese expert consensus on diagnostic vitrectomy for biopsy (2022)]. Vitreoretinal Surgery in the Prevention and Treatment of Toxic Tumour Syndrome in Uveal Melanoma: A Systematic Review.","links":[{"label":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis.","url":"https://pubmed.ncbi.nlm.nih.gov/35987957/"},{"label":"[Chinese expert consensus on diagnostic vitrectomy for biopsy (2022)].","url":"https://pubmed.ncbi.nlm.nih.gov/36480882/"},{"label":"Vitreoretinal Surgery in the Prevention and Treatment of Toxic Tumour Syndrome in Uveal Melanoma: A Systematic Review.","url":"https://pubmed.ncbi.nlm.nih.gov/34576231/"}]},{"id":"narrative-outcomes_and_limits","title":"Expected outcomes and limits of the evidence","text":"Expected outcomes and limits of the evidence In the COMS trial, the iodine-125 plaque treatment group included 650 treated patients with choroidal melanoma. Their tumours measured 2.5–10.0 mm in height and no more than 16.0 mm across the base. Patients entered the trial between 1987 and 1998, so these are historical treatment results. Follow-up lasted at least one year for 638 patients and at least five years for 411. Within the first five years, 69 eyes were removed and treatment failure was reported in 57 eyes. Treatment failure meant tumour growth, recurrence or spread through the outer wall of the eye. The estimated five-year risk was 12.5% for eye removal and 10.3% for treatment failure, calculated using a method that accounts for differences in follow-up time. These results describe plaque treatment in this defined patient group, not expected results for every eye tumour or a direct comparison with eye-removal surgery. Sources (1) The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19.","links":[{"label":"The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19.","url":"https://pubmed.ncbi.nlm.nih.gov/32200815/"}]},{"id":"narrative-risks","title":"Risks to discuss with your surgeon","text":"Risks to discuss with your surgeon For ocular surface squamous neoplasia, dry eye was the most commonly reported side effect across surgical excision and the topical medicines studied. For choroidal melanoma treated with a radiation plaque, further treatment can include removal of the eye; tumour treatment failure was the most common reason for this within the first three years in the COMS trial. After radiation for uveal melanoma, dead tumour tissue remaining inside the eye can cause toxic tumour syndrome, a serious blood-vessel complication that threatens the eye and its function. Surgery inside the eye has been used to prevent or treat this complication in selected patients, with the choice and timing depending on the tumour and the condition of the eye. Sources (3) Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis. The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19. Vitreoretinal Surgery in the Prevention and Treatment of Toxic Tumour Syndrome in Uveal Melanoma: A Systematic Review.","links":[{"label":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis.","url":"https://pubmed.ncbi.nlm.nih.gov/35987957/"},{"label":"The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19.","url":"https://pubmed.ncbi.nlm.nih.gov/32200815/"},{"label":"Vitreoretinal Surgery in the Prevention and Treatment of Toxic Tumour Syndrome in Uveal Melanoma: A Systematic Review.","url":"https://pubmed.ncbi.nlm.nih.gov/34576231/"}]},{"id":"narrative-recovery_and_followup","title":"Recovery and follow-up care","text":"Recovery and follow-up care Follow-up after treatment can address both the treated eye and the possibility of cancer spreading elsewhere. In the COMS plaque-treatment trial, eye examinations included ultrasound and photographs of the back of the eye before treatment, every six months for five years, then annually. This was the trial's schedule. For uveal melanoma, control of the tumour in the eye does not eliminate the possibility of spread, particularly to the liver. A Scottish consensus statement published in 2023 describes follow-up for posterior uveal melanoma based on low-to-medium or high risk of spread. That framework was adopted in Scotland, but it was consensus-based because adequate evidence to establish the surveillance strategy was lacking; it is not a universal follow-up schedule. Sources (2) The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19. Consensus statement for metastatic surveillance of uveal melanoma in Scotland.","links":[{"label":"The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19.","url":"https://pubmed.ncbi.nlm.nih.gov/32200815/"},{"label":"Consensus statement for metastatic surveillance of uveal melanoma in Scotland.","url":"https://pubmed.ncbi.nlm.nih.gov/35945341/"}]},{"id":"explore","title":"Explore surgery and care teams","text":"Explore surgery and care teams Other cancers and specialized treatments: surgery and treatment options Other cancers and specialized treatments: surgeons Other cancers and specialized treatments: clinics","links":[{"label":"Other cancers and specialized treatments: surgery and treatment options","url":"https://hub.bookimed.com/oncologic-surgery/organ-special/"},{"label":"Other cancers and specialized treatments: surgeons","url":"https://hub.bookimed.com/oncologic-surgery/surgeons-organ-special/"},{"label":"Other cancers and specialized treatments: clinics","url":"https://hub.bookimed.com/oncologic-surgery/clinics-organ-special/"}]},{"id":"research","title":"Research and sources","text":"Research and sources Sources (18) PTCOG Ocular Statement: Expert Summary of Current Practices and Future Developments in Ocular Proton Therapy. Head and neck melanoma (excluding ocular melanoma): United Kingdom National Multidisciplinary Guidelines. Consensus statement for metastatic surveillance of uveal melanoma in Scotland. [Chinese expert consensus on diagnostic vitrectomy for biopsy (2022)]. Prevalence, Risk Factors and Management of Ocular Rhabdomyosarcoma (ORMS) in Africa: A Systematic Review. Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis. Anti-epidermal growth factor receptor therapy for glioblastoma in adults. Pattern of Orbito-ocular Tumours in Nigeria: a systematic review. Experience in treating children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle and systematic review. Pediatric Cataract Surgery Following Treatment for Retinoblastoma: A Case Series and Systematic Review. Ocular metastasis of primary gynecological malignancies, a rare but not insignificant entity: A systematic review. Nonosseous Periocular Manifestations of Langerhans Cell Histiocytosis: A Case Report and Systematic Review. Vitreoretinal Surgery in the Prevention and Treatment of Toxic Tumour Syndrome in Uveal Melanoma: A Systematic Review. Apatinib in recurrent anaplastic meningioma: a retrospective case series and systematic literature review. Paediatric Horner's syndrome: is investigation for underlying malignancy always required? Chemosaturation Percutaneous Hepatic Perfusion: A Systematic Review. The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19. Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device.","links":[{"label":"PTCOG Ocular Statement: Expert Summary of Current Practices and Future Developments in Ocular Proton Therapy.","url":"https://pubmed.ncbi.nlm.nih.gov/38971383/"},{"label":"Head and neck melanoma (excluding ocular melanoma): United Kingdom National Multidisciplinary Guidelines.","url":"https://pubmed.ncbi.nlm.nih.gov/27841141/"},{"label":"Consensus statement for metastatic surveillance of uveal melanoma in Scotland.","url":"https://pubmed.ncbi.nlm.nih.gov/35945341/"},{"label":"[Chinese expert consensus on diagnostic vitrectomy for biopsy (2022)].","url":"https://pubmed.ncbi.nlm.nih.gov/36480882/"},{"label":"Prevalence, Risk Factors and Management of Ocular Rhabdomyosarcoma (ORMS) in Africa: A Systematic Review.","url":"https://pubmed.ncbi.nlm.nih.gov/40884314/"},{"label":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis.","url":"https://pubmed.ncbi.nlm.nih.gov/35987957/"},{"label":"Anti-epidermal growth factor receptor therapy for glioblastoma in adults.","url":"https://pubmed.ncbi.nlm.nih.gov/32395825/"},{"label":"Pattern of Orbito-ocular Tumours in Nigeria: a systematic review.","url":"https://pubmed.ncbi.nlm.nih.gov/39922999/"},{"label":"Experience in treating children with ocular dyskinesia and hemifacial spasm secondary to pontine tumours adjacent to the fourth ventricle and systematic review.","url":"https://pubmed.ncbi.nlm.nih.gov/38227027/"},{"label":"Pediatric Cataract Surgery Following Treatment for Retinoblastoma: A Case Series and Systematic Review.","url":"https://pubmed.ncbi.nlm.nih.gov/35172168/"},{"label":"Ocular metastasis of primary gynecological malignancies, a rare but not insignificant entity: A systematic review.","url":"https://pubmed.ncbi.nlm.nih.gov/35708414/"},{"label":"Nonosseous Periocular Manifestations of Langerhans Cell Histiocytosis: A Case Report and Systematic Review.","url":"https://pubmed.ncbi.nlm.nih.gov/33315841/"},{"label":"Vitreoretinal Surgery in the Prevention and Treatment of Toxic Tumour Syndrome in Uveal Melanoma: A Systematic Review.","url":"https://pubmed.ncbi.nlm.nih.gov/34576231/"},{"label":"Apatinib in recurrent anaplastic meningioma: a retrospective case series and systematic literature review.","url":"https://pubmed.ncbi.nlm.nih.gov/32212907/"},{"label":"Paediatric Horner's syndrome: is investigation for underlying malignancy always required?","url":"https://pubmed.ncbi.nlm.nih.gov/31186293/"},{"label":"Chemosaturation Percutaneous Hepatic Perfusion: A Systematic Review.","url":"https://pubmed.ncbi.nlm.nih.gov/27798773/"},{"label":"The COMS Randomized Trial of Iodine 125 Brachytherapy for Choroidal Melanoma: IV. Local Treatment Failure and Enucleation in the First 5 Years after Brachytherapy. COMS Report No. 19.","url":"https://pubmed.ncbi.nlm.nih.gov/32200815/"},{"label":"Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device.","url":"https://pubmed.ncbi.nlm.nih.gov/32424568/"}]},{"id":"request","title":"Request a treatment proposal","text":"Request a treatment proposal Share your diagnosis and reports through the Bookimed request form.","links":[]},{"id":"request-form","title":"Ask about treatment","text":"Ask about treatment What would you like help with? Answer a few questions on Bookimed, then add your contact details to request help. Privacy policy Open the Bookimed request form","links":[{"label":"Privacy policy","url":"https://us-uk.bookimed.com/page/privacy-policy/"}]}],"introduction":"Oncologic surgery guide / Ocular oncology surgery Decision guide Ocular oncology surgery Ocular oncology surgery covers different procedures for eye tumours rather than one operation. Research project led by Yevhenii Kozlov · Co-Founder of Bookimed Updated 21 October 2026 Sources linked throughout","related_documents":[{"id":"oncologic-surgery","title":"Oncologic surgery: explore care by organ","kind":"home","url":"https://hub.bookimed.com/oncologic-surgery/","json_url":"https://hub.bookimed.com/oncologic-surgery/page-contexts/oncologic-surgery.json"},{"id":"organ-special","title":"Other cancers and specialized treatments: surgery and treatment options","kind":"guide","url":"https://hub.bookimed.com/oncologic-surgery/organ-special/","json_url":"https://hub.bookimed.com/oncologic-surgery/organ-special/#page-context"},{"id":"surgeons-organ-special","title":"Other cancers and specialized treatments: surgeons","kind":"specialist-directory","url":"https://hub.bookimed.com/oncologic-surgery/surgeons-organ-special/","json_url":"https://hub.bookimed.com/oncologic-surgery/surgeons-organ-special/#page-context"},{"id":"clinics-organ-special","title":"Other cancers and 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