IntroductionTo evaluate the outcome of local resectionversuscombined local resection and plaque radiotherapy in the treatment of choroidal melanoma.Material and MethodsWe retrospectively analyzed the records of 60 patients (60 eyes) managed by local resection (group 1, 30 patients, both external or internal local resection) or combined local resection and plaque radiotherapy (group 2, 30 patients both Ruthenium-106 or Cobalt-60), among the 364 melanomas treated at our Department of Ophthalmology, between January 1980 and December 2006. Main outcomes measures were post-surgical complications, visual acuity, local recurrence, reasons for enucleation, and development of metastasis.ResultsThe two groups of patients were considered sufficiently homogeneous as regards location, cell-type, and age. Mean follow up was 7 years. The median largest basal tumor diameter was 9.8 mm and 10.1 mm, and the median tumour thickness was 7.9 mm and 8 mm, respectively in group 1 and 2. No statistically significant differences resulted between group 1 and group 2, as regards post-surgical complications (vitreus hemorrhage, retinal detachment, maculopathy, cataract, andoptic neuropathy) (p > .05), visual acuity (p > .05), and as regards local recurrence (p > .05), reasons for enucleation (p > .05), and development of metastasis (p > .05).DiscussionNo adjunctive safety or efficacy from the combined local resection and plaque radiotherapy, when compared to local resection, can be ruled out from our study.ConclusionEnucleation today should be relegated only to that cases in which there is no other possibilities. No adjunctive benefits from the combined local resection and plaque radiotherapy can be ruled out from our study.