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This study presents a practical stepwise treatment algorithm for conjunctival melanocytic lesions from low-grade intraepithelial lesions (LG-CMIL) to invasive melanoma (iCoM). Key findings include the identification of non-bulbar involvement and residual pigmentation as independent risk factors for local recurrence and ulcerative features as a strong predictor of metastatic spread. The multimodal approach incorporating surgery, topical chemotherapy, and radiotherapy demonstrates promising local disease control outcomes.
