PDF(Pubmed)
Abstract：
Surgical placement of eye plaque brachytherapy (EPB) is the standard of care for the treatment of uveal melanomas, including iris/iridociliary melanomas. However, unique challenges exist in anterior EPB placement. Here, we describe a surgical technique for anterior EPB placement when placement requires plaque positioning onto the cornea. Blunt conjunctival peritomy exposes the sclera overlying the tumor. A \"dummy\" plaque is placed, with positioning confirmed by direct visualization. The amniotic membrane is draped across the cornea and anchored with the eyelet sutures, the plaque is placed overlying the membrane, the conjunctiva is closed over the plaque, and a temporary tarsorrhaphy is performed. One week later, the conjunctival incision is reopened for plaque/amniotic membrane removal. This technique was employed in the treatment of 12 iris/iridociliary melanomas at our institution, with no instances of corneal damage. In placing an anterior plaque, employing this technique allows appropriate cancer treatment while optimizing patient comfort and corneal integrity.
摘要：
■眼斑近距离放射治疗（EPB）的手术放置是治疗葡萄膜黑素瘤的标准护理，包括虹膜/虹膜睫状黑色素瘤。然而,前EPB放置存在独特的挑战。这里,我们描述了当放置需要在角膜上定位斑块时，用于前EPB放置的手术技术。闭合性结膜周围切开术暴露了覆盖肿瘤的巩膜。放置一个“虚拟”牌匾，通过直接可视化确认定位。羊膜覆盖在角膜上，并用孔眼缝线固定，斑块被放置在膜上，结膜在斑块上闭合，并进行了临时挂毯。一周后,结膜切口重新开放以去除斑块/羊膜。该技术在我们机构中用于治疗12个虹膜/虹膜睫状黑色素瘤，没有角膜损伤的情况。在放置前斑块时，采用这种技术可以进行适当的癌症治疗，同时优化患者的舒适度和角膜完整性。
