Tissue Glue Adhesion for Plaque Radiotherapy of Uveal Melanoma in Humans, an Initial Experience

Purpose: To study use of tissue glue instead of conventional suturing, to secure I-125 plaque in human eyes with uveal melanoma. Methods: We studied six patients with choroidal melanoma undergoing plaque radiotherapy who were found to have thin sclera intra-operatively. Following tumor localization and plaque placement, tissue glue was applied over and around the plaque surface. The plaque was held securely in all cases. Conjunctivoplasty was performed with 7-0 vicryl sutures to ensure complete coverage and stability of the plaque. At the time of plaque removal, the tissue glue clot was in place with plaque secured. The clot and plaque were removed without difficulty. Results: In all six cases, the tissue glue secured the plaque in place for the required radiation duration (mean 117.6 hours (hrs), median 103.1 hrs, range 101.6-162.5 hrs) delivering a tumor apex dose (mean 63.6 cGy/hr, median 69.6 cGy/hr, range 44.7-70.5 cGy/hr). At the time of plaque removal, the plaque was in the designated position without displacement in all cases. There were no toxicities from the tissue glue. Conclusions: Tissue glue can serve as an alternative for fixation of plaque radiotherapy to the sclera without the need for suturing. This technique might be useful in eyes with thin sclera.