A new study led by UCLA suggests that a surgical technique developed to protect vision in people with uveal melanoma—a rare cancer that begins inside the eye—may do more than just save sight.
It could also reduce the risk of the cancer spreading and improve survival, a finding that researchers say could change how this disease is treated.
The study, published in Cancers, followed 37 patients treated for uveal melanoma.
Most of them received a common form of targeted radiation therapy known as plaque brachytherapy.
In addition, surgeons performed a procedure that replaces the eye’s natural gel-like substance (the vitreous) with silicone oil.
This specialized step shields healthy parts of the eye from radiation damage while ensuring the tumor still gets a strong enough dose to destroy cancer cells.
Over a median follow-up of more than four years, the results were striking. More than 80% of patients remained free of cancer spread, and none experienced a recurrence in the treated eye.
Only six patients developed metastases—far fewer than expected based on historical data, where around 30% of patients typically see their cancer spread, most often to the liver. Just one patient died from the disease during the study period.
Dr. Tara McCannel, director of the Ophthalmic Oncology Center at the UCLA Stein Eye Institute and senior author of the study, explained the significance: “Everything about uveal melanoma has always been painted with limited hope, with patients expected to lose vision and eventually die once the cancer spreads.
We know that this unique surgical technique clearly saves vision. However, we did not expect the technique to alter metastasis and mortality. And anything that improves survival in uveal melanoma is a game-changer.”
The technique was first pioneered at UCLA more than a decade ago, and earlier research showed it protected against radiation-related vision loss.
But the survival benefit only became clear when Dr. Wolfram Samlowski, a medical oncologist in Las Vegas who was monitoring patients for metastasis, noticed that he wasn’t seeing UCLA patients develop the expected complications. This observation prompted a closer look at long-term outcomes.
The researchers analyzed both clinical results and genetic risk factors. Even patients classified as “high risk” based on tumor genetics showed surprisingly low rates of metastasis and death. In fact, tumor size and stage turned out to be poor predictors of whether the cancer would spread in this group.
While the findings are encouraging, the researchers caution that more studies are needed to confirm whether the improved outcomes come from the surgery itself, the way radiation is delivered, or a combination of factors.
They also note that placing silicone oil requires advanced retinal surgery skills, meaning more training will be needed for wider adoption.
Still, the results offer rare hope for people with uveal melanoma, showing that a procedure once designed only to save sight may also help save lives.
