Treatment of large von Hippel tumors by eye wall resection.

Two large angiomas (greater than 3 disc diameters) in two patients with von Hippel disease were removed successfully by eye wall resection. The resection of angioma in the first case resulted in improved visual acuity from counting fingers to 20/140, decreased exudates, and cessation of preoperative diffuse retinal capillary leakage observed by fluorescein angiography. The resection in the second case with pre-existing local tractional retinal detachment was tolerated well. The patient retained her preoperative visual acuity of 20/25, and retinal traction was released. Although a complicated surgical procedure, resection of large angiomas offers a good alternative therapy to tumors resistant to cryocoagulation or photocoagulation.