Lomi Neiwete, Chawla Bhavna, Das Deepsekhar
Dr. R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2024 Feb 1;72(2):303. doi: 10.4103/IJO.IJO_2213_23. Epub 2024 Jan 25.
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.
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.
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.
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.
斑块近距离放射治疗常用于脉络膜黑色素瘤的治疗。手术步骤通常包括进行结膜环切术，固定直肌，根据病变位置决定是否离断直肌，以及放置斑块。下斜肌附着于黄斑附近，在黄斑周围或视乳头周围病变的情况下，需要牺牲该肌肉。
本文作者展示了一种在黄斑周围或视乳头周围脉络膜黑色素瘤病例中放置放射性斑块而不离断下斜肌的新技术。
该视频展示了近距离放射治疗斑块放置的“离断、牵拉和旋转技术”如何实施以及该技术背后的基本原理。作者已多次进行此操作，未发生斑块倾斜或移位的情况。
在黄斑周围和视乳头周围脉络膜黑色素瘤近距离放射治疗斑块放置中，可以保留 下斜肌。该简单技术不会导致放射性斑块出现任何倾斜或移位。
