Thermotherapy by the transpupillary route is an effective outpatient eye-salvaging therapy for intraocular tumors. It does not require surgery, it can be repeated, and it does not affect the healthy structures of the eye. TTT reduces the need for enucleation, because it can effectively treat tumors that respond insufficiently to radiation. TTT combined with brachytherapy, or sandwich therapy, permits conservative treatment of larger uveal melanomas when compared with brachytherapy as the sole therapy. Thermotherapy by the transscleral route may have potential in the treatment of choroidal melanomas. TSTT combined with TTT may be an alternative to brachytherapy in sandwich therapy, because the laser beam, in contrast to radiation from the plaque, can be aimed precisely at the target area, resulting in a sharp demarcation that may offer improved visual outcomes. Currently, the indications for chemoreduction, thermochemotherapy, and thermotherapy for retinoblastoma are under investigation. Thermotherapy for retinoblastoma should be offered as part of an institutional clinical trial at a specialized center.
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