Purpose To report on an unusual form of adult onset iris melanoma as melanomalytic glaucoma. Methods A 35‐year‐old white male with a history of unilateral ocular hypertension and visual loss for six months. Results At first visit,Best Corrected Visual Acuity was 80/20 in the right eye (OD) and 20/20 in the left one (OS).Intraocular pressure was 40 mmHg in the OD and 10 mmHg in OS.Anterior segment examination of the OD showed a melanotic elevated lesion on the base of the iris from 8:00 to 9:00.Gonioscopy revealed extension into the anterior chamber angle and that a dense, brown, pigmented band at the filtration portion of the trabecular meshwork. Ophthalmoscopy demonstrated glaucomatous changes to the right optic disc. The patient was unresponsive to medical treatment for glaucoma. The clinical differential diagnosis was melanocytoma, nevus and melanoma. Excisional biopsy ( iridocycloresection ) was performed. Light microscopy showed proliferation of fusiform cells with pleomorphic nuclei in the iris stroma, immunopositive for HMB45 and Melan‐A. The final hystopathologic diagnosis was iris melanoma with dispersion of pigment in anterior‐chamber and secondary melanomalytic glaucoma. Plaque radiotherapy was performed as a Conclusion In patients presenting unilateral glaucoma and increased pigmentation in the trabecular meswork it is crucial to perform imaging studies, such as ultrasound, in order to rule out the presence of an intraocular tumor. Early diagnosis improves the patients visual prognosis and the morbidity of treatments. Resection by iridectomy with adjuvant epiescleral brachytheraphy is effective in controlling the disease.

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Purpose The aim of this study is to present the results of pars plana vitrectomy in patients with advanced disease and to identify preoperative risk factors and postoperative visual outcome. Methods The study was carried out at the University Hospital in Valladolid (Spain) with data from patients throughout two years. Results Retrospective chart review of patients who underwent posterior plas plana vitrectomy (PPV) during 2010‐2011 for non‐clearing vitreous haemorrhage (NCVH), tractional retinal detachment (TDR) or diabetic edema with vitreomacular traction (TME) and followed for at least 6 months.The primary outcome measure was the best corrected visual acuity (BCVA) at the end of the follow‐up period and its correlation with preoperative risk factors.The secondary outcomes were postoperative complications and the influence of the status of the external retina in the ocular coherence tomography (OCT). 58 patients underwent PPV for advanced retinal disease. NCVH was the most frequent surgical indication in 32 patients and 21 of them had gone through laser previously. Mean preoparative BCVA was 1.96 ± 1.13 logarithm of minimum angle of resolution (logMAR) units and it improved.TDR was the indication in 10 patients. Only 50% of them had laser and all of them suffered from long term disease. There was not significant improvement in the BCVA and 3 patients developed neovascular glaucoma. Ind Conclusion Preoperative BCVA, long term disease, the lack of laser treatment and the external retina seem to be some of the most important risk factors in these patients.

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