Outcomes of Choroidal Melanoma 25-Gauge Vitrectomy Needle Biopsy and Iodine 125 Brachytherapy Performed by Directly Supervised Fellows versus Attending Faculty.

Purpose: To evaluate the outcomes of choroidal melanoma 25-gauge vitrectomy needle biopsy and iodine 125 (I) brachytherapy performed by supervised fellows compared with experienced faculty.

Design: Retrospective, observational case series.

Participants: Sixty-three consecutive eyes of 63 patients with treatment-naïve medium choroidal melanomas without extraocular extension.

Methods: Sixty-three consecutive eyes of 63 patients undergoing simultaneous I brachytherapy and 25-gauge vitrectomy melanoma biopsy for choroidal melanoma. One attending surgeon performed 31 surgeries and 2 fellows performed 32 surgeries. All cases treated by fellows were under direct supervision of the attending physician.

Main Outcome Measures: Percentage of adequate biopsy sample, tumor regression, and postoperative complications.

Results: There were no baseline differences between the groups. The biopsy yield for gene expression profile and the melanoma regression rate were equal in both groups (63/63 [100%]; P = 1.0). Complications occurred in 1 of 31 faculty surgery patients (transient vitreous hemorrhage) and in 0 of 32 fellow surgery patients (P = 1.0).

Conclusions: With proper supervision, fellows can achieve equally high biopsy yield and melanoma regression rate with few complications compared with experienced faculty.