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A retrospective analysis of 1794 radiotherapy-treated patients (2012–2022) identified 70 cases undergoing secondary vitrectomy, evaluating overall tumour control and visual outcomes. Proton-beam radiotherapy showed higher complication rates than plaque brachytherapy, including vitreous haemorrhage and retinal detachment/toxic tumour syndrome. 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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Liverpool Ocular Oncology Centre, Prescott Street, Liverpool L7 8XP, UK; [carl.groenewald@liverpoolft.nhs.uk](carl.groenewald@liverpoolft.nhs.uk) (C.G.); [heinrich.heimann@liverpoolft.nhs.uk](heinrich.heimann@liverpoolft.nhs.uk) (H.H.)  \n2 Research & Innovation Department, NHS University Hospitals of Liverpool Group, Edwards Building, Liverpool L7 8YE, UK; [antonio.eleuteri@liverpoolft.nhs.uk](antonio.eleuteri@liverpoolft.nhs.uk)  \n3 Liverpool Ocular Oncology Research Group, Department of Eye and Vision Science, Institute of Life Course and Medical Sciences (ILCaMS), University of Liverpool, Liverpool L7 8TX, UK; [hung-da.chou@liverpoolft.nhs.uk](hung-da.chou@liverpoolft.nhs.uk)  \n* Correspondence: [t.padley@nhs.net](t.padley@nhs.net) (T.J.P.); [rumana.hussain@liverpool.ac.uk](rumana.hussain@liverpool.ac.uk) (R.H.); Tel.: +44-7492-594625 (T.J.P.)  \nSimple Summary  \nUveal melanoma is a rare eye cancer that is commonly treated with radiotherapy, as it provides an opportunity for treatment while allowing patients to keep their eye rather than having it surgically removed. This treatment can, however, lead to complications needing surgery, often a procedure called a vitrectomy. In this study, we analysed patients who underwent vitrectomy after radiotherapy to better understand future visual quality and the degree of tumour control. We found that these patients often had aggressive cancersand were more likely to suffer a decline in vision, exhibit a lack of tumour control, and more commonly require removal of the affected eye. The findings highlight the importance of collaborative management between oncologists and eye surgeons. This data allows both doctors and patient to understand the possible risks before starting radiotherapy treatment.  \nAbstract  \n(1) Background: Globe-sparing radiotherapy is widely utilised in the treatment of uveal melanoma, but often results in complications requiring vitreoretinal intervention. The outcomes of secondary vitrectomy remain unclear. A multidisciplinary approach involving vitreoretinal and ocular oncology specialists is essential to managing complications.  \n(2) Methods: We reviewed 1794 patients treated with radiotherapy for uveal melanoma between 2012 and 2022 . In total, 70 patients underwent secondary vitrectomy after primary radiotherapy treatment. The outcomes included overall tumour control and visual outcome.  \n(3) Results: Complications requiring vitrectomy were more common after proton-beam radiotherapy than plaque brachytherapy (5.4% versus 3.0%) . Common indications included vitreous haemorrhage (39%) and retinal detachment/toxic tumour syndrome (31%) . The affected tumours were larger, more often ciliary body in origin, and associated with a worse prognosis. Vitrectomy patients had higher rates of enucleation (9% versus 3%), metastasis (16% versus 6%), and visual decline (average 0.60 LogMAR), with limited visual improvement (≥3-line gain in 13%) . Proton-beam patients had worse outcomes than plaque brachytherapy patients. (4) Conclusions: Vitreoretinal complications after uveal melanoma radiotherapy are rare, but timely treatment by those with experience may enable patients to keep their eye in situations where enucleation would be the only alternative. Patients and clinicians must understand the risks of complications to make informed decisions about treatment plans, with vitreoretinal su","cbCaigdpij93bPoJ","https://ap.wps.com/l/cbCaigdpij93bPoJ","pdf",786835,16,"English","# Simple Summary\n# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# 1. Introduction","[{\"question\":\"Why is radiotherapy commonly used for uveal melanoma instead of enucleation?\",\"answer\":\"Radiotherapy is used because it can control the tumour while preserving the eye, avoiding the physical and psychological impacts of eye removal. However, it can lead to complications requiring vitreoretinal surgery.\"},{\"question\":\"How many patients received secondary vitrectomy after primary radiotherapy, and what outcomes were assessed?\",\"answer\":\"Among 1794 radiotherapy-treated patients (2012–2022), 70 underwent secondary vitrectomy. Outcomes included overall tumour control and visual outcome.\"},{\"question\":\"Which radiotherapy approach was associated with more vitrectomy-requiring complications?\",\"answer\":\"Complications requiring vitrectomy were more common after proton-beam radiotherapy than after plaque brachytherapy (5.4% versus 3.0%). Proton-beam patients also had worse outcomes.\"}]","Vitreoretinal Surgery for Intraocular Complications Following Radiotherapy Treatment of Uveal Melanoma | PDF",1790768713]