The use of imbricated sutures in radioactive plaque brachytherapy surgery

Abstract

Kaan Gündüz1, Jose S Pulido1, Peter D Yeakel2, Michael King3, Kelly L Classic1, Keith M Furutani21Department of Ophthalmology, 2Department of Radiation Oncology, 3Section of Media Support Services, Mayo Clinic, Rochester, MN, USAAbstract: This paper describes a new technique to suture the radioactive plaque to sclera. The radioactive plaque is conventionally sutured to the sclera using 5/0 nylon sutures. The imbricated suture technique involves using a 1/0 silk or 2/0 mersilene suture imbricated with the 5/0 nylon suture when the nylon suture is tied and cut. The imbricated suture technique allows easy identification of the plaque at removal and provides a surface that separates the 5/0 nylon from the surface of the eyelet platform, making suture cutting easier and safer. The radiation exposure times ranged from 9.1 minutes to 14 minutes (mean: 10.8 minutes) during plaque insertion and from 2.8 to 3.3 minutes (mean: 3.0 minutes) during plaque removal with the imbricated suture technique. This technique may decrease radiation exposure time and may prevent inadvertent scleral damage.Keywords: plaque radiotherapy, Iodine-125, Ruthenium-106, Collaborative Ocular Melanoma Study, choroidal melanoma, ciliary body melanoma, retinoblastoma, plaque placement, plaque removal, radiation exposure