Uveal Melanoma Treatment & Surgery
Ocular oncologist and vitreoretinal surgeon Amy Schefler, MD, is one of few national experts in eye tumor and retinal disease diagnosis and treatment. We are committed to ensuring each patient receives expert care in a compassionate, collaborative and innovative environment.
Personalized Treatment Plans
Schefler and her team, including radiation oncologists, oncologists, radiation physicists and pathologists, are passionate about their work and spend vast amounts of time examining minute details of every patient’s treatment plan. We design custom brachytherapy plaques based on the size, shape and contour of each patient’s specific tumor. Our specialists have performed hundreds of these procedures, and this commitment to excellence minimizes radiation damage to healthy eye parts while maximizing tumor treatment.
Schefler performs real-time ultrasound in the operating room to ensure our plaques are perfectly centered over the patient’s tumor. Our team has achieved a zero-percent local recurrence rate — meaning tumors have not regrown at the treatment site in the past five years. We ensure plaques cover each tumor, which takes extra time and intense attention to detail.
Patient Story - Darrell
A friend’s cataract surgery reminded Darrell that he needed an eye exam. His decision to have an eye exam was a wise one, because the retinal specialist in Alaska detected cancer and sent him to Houston Methodist to receive care for uveal melanoma, a rare eye cancer. Darrell was fortunate to find the expertise he needed for his rare form of cancer at Houston Methodist.
Fine-needle aspiration biopsies enable our team to confirm uveal melanoma, perform genomic analysis of tumor cells and perform genomic research. Genomic analysis helps determine the patient’s risk of developing metastatic disease (cancer that spreads from the eye to other parts of the body). Many clinical trials require this information.
Patients with relatively small tumors and/or tumors near critical eye structures (optic nerve or macula) routinely undergo biopsies without complications because of our team’s extensive surgical experience.
Plaque Surgery (Brachytherapy)
Radiation beads, known as seeds, are chosen and designed for each patient based on tumor size, shape and configuration. The seeds are placed in a gold-backed, bottle cap-shaped implant to protect healthy surrounding tissues. The radiation patch is inserted onto the eye’s outside surface during a surgical procedure, where it remains while the radiation treats the tumor.
After several days, the patch is removed during a second surgery. The radiation kills the tumor cells, and patients keep their eyes, as well as enjoy good vision. The entire treatment occurs on an outpatient basis.
Enucleation (permanent surgical removal of the eye)
Enucleation, the oldest form of uveal melanoma treatment, leaves intact the eye muscles, as well as the conjunctiva (the skin of the eye) and eyelids. A sphere-shaped implant is inserted into the orbital cavity to fill the space, and the patient’s eye muscles are attached to the implant to create movement.
After the tissues heal, the patient is referred to an ocularist, who fits the patient for an ocular prosthesis painted to match the patient’s other eye. The prosthesis does not move like a normal eye, but looks natural. The treatment is fast, definitive and requires limited ophthalmic follow up, but the patient loses vision in the affected eye.
Our team is enrolling clinical trials for experimental uveal melanoma treatments. Some of these treatments may minimize vision loss for patients with smaller tumors near critical anatomic structures, such as the macula and optic nerve.