Disinsert, retract and rotate technique of plaque brachytherapy

Background: Plaque brachytherapy is commonly used in the management of choroidal melanomas. The surgical steps usually involve creating a conjunctival peritomy, fixing the recti muscles, with or without disinserting them based on the location of the lesion, and placing the plaque. The inferior obliq...

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Bibliographic Details
Main Authors: Neiwete Lomi, Bhavna Chawla, Deepsekhar Das
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-01-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2024;volume=72;issue=2;spage=303;epage=303;aulast=Lomi
Description
Summary:Background: Plaque brachytherapy is commonly used in the management of choroidal melanomas. The surgical steps usually involve creating a conjunctival peritomy, fixing the recti muscles, with or without disinserting them based on the location of the lesion, and placing the plaque. The inferior oblique muscle is attached close to the macula, and in cases of perimacular or peripapillary lesions, the muscle needs to be sacrificed. Purpose: The authors here demonstrate a novel technique of placing radioactive plaque without disinserting the inferior oblique muscle in cases of perimacular or peripapillary choroidal melanomas. Synopsis: The video demonstrates how the “disinsert, retract, and rotate technique” of brachytherapy plaque placement can be performed and what are the fundamentals behind this technique. The authors have performed this procedure multiple times and there has been no incidence of plaque tilt or migration. Highlights: In perimacular and peripapillary choroidal melanoma brachytherapy plaque placement, the inferior oblique muscle can be spared. The simple technique does not lead to any tilt or migration of the radioactive plaque. Video Link: https://youtu.be/YMIg3rYyp2o
ISSN:0301-4738
1998-3689