TISSUE GLUE-ASSISTED PLAQUE RADIOTHERAPY FOR CHOROIDAL TUMORS WITH SCLERAL THINNING.

Abstract

To evaluate tissue glue-assisted plaque placement regarding accuracy, stability, and longer-term outcomes for choroidal tumors with scleral thinning. All patients with tissue glue-assisted plaque radiotherapy at a single ocular oncology center were evaluated for patient demographics, tumor features, surgical details, tumor response, and glue-related complications. There were 13 patients (mean age 72 years) treated with tissue glue-assisted plaque radiotherapy for choroidal melanoma (n = 12) or choroidal metastasis (n = 1). At presentation, the tumor was mean 4.3 mm to the optic disk and 2.0 mm to the foveola with a mean basal diameter of 9.5 mm and a thickness of 4.2 mm. In all cases, the tissue glue-assistance was used due to extreme scleral thinning in the bed of proposed radiation. The plaque size was 15 mm (n = 5), 18 mm (n = 7), or 20 mm (n = 1). At application, there was no immediate glue hypersensitivity, ultrasonography confirmed accuracy of placement, and the glue remained adherent for the entire treatment duration (mean 113 hours) with stable plaque location at removal. At removal, the plaque-glue composite was peeled off the globe without need for glue dissolvent and without scleral disruption. At 12 months, mean melanoma thickness was 2.7 mm (regression 36%). There were no conjunctival, corneal, or scleral complications. Tissue glue-assisted plaque radiotherapy is safe and effective for treatment of choroidal tumors with thin sclera.