We retrospectively analyzed data from records of 48 patients (48 eyes) treated with gamma-knife (n = 18) or
Ruthenium-106 brachytherapy (
n = 30) for
uveal melanoma, in our Ocular Oncology Unit between December 2013 and September 2019, with the aim to evaluate treatment outcomes, and incidence and risk factors for secondary
glaucoma. Patients demographics and
tumor characteristics at diagnosis were recorded. Follow-up data were collected regarding local
tumor control, treatment complications, enucleation need,
metastases occurrence and survival status. The median follow-up period was 33.7 months in the gamma-knife group and 26.2 months in the
brachytherapy group. The mean
tumor thickness, the largest basal diameter and the
tumor volume were significantly higher in the gamma-knife group than in the
brachytherapy group. The local
tumor control rate was 100% in the
brachytherapy group and 77.8% in the gamma-knife group. In the gamma-knife group, six patients were enucleated, no patient treated with
brachytherapy underwent enucleation. The overall survival rate was 96.7% in the
brachytherapy group and 94.44% in the gamma-knife group. Secondary
glaucoma occurred in 10 patients after gamma-knife and in one patient after
brachytherapy: it should be emphasized that larger lesions were treated with gamma-knife, whereas smaller
tumors were selected for
brachytherapy. We found a significative correlation of
tumor thickness (P value = 0.043) and volume (P value = 0.040) with secondary
glaucoma occurrence after gamma-knife treatment. Moreover, secondary
glaucoma significantly correlated with radiation retinopathy in the gamma-knife group (P value = 0.009). This study shows preliminary clinical results that could be useful for further studies with more patients and longer follow-up.